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NCAHF Position Paper on Nutrition Diploma Mills in California


Special Terms

FOOD FADDISM:  A general term used to designate nutrition nonsense. Food faddism is characterized as much by its exaggerations as absolute errors about nutrition and diet.

QUACK:  "Anyone who promotes medical schemes or remedies known to be false, or which are unproven, for a profit."* (U.S. House of Representatives, May, 1984).  *In the opinion of the NCAHF offering such goods or services for a donation or through alleged "nonprofit" schemes still constitutes quackery.

NUTRITION QUACKERY:  Utilizing invalid methods for assessing an individual's nutritional status, or promoting the use of food supplements, nutrition substances or special diets that lack reasonable scientific evidence of safety and effectiveness to cure, treat or prevent disease, increase longevity, enhance physical, sexual, or mental performance.

DEGREE MILL:  "An organization that awards degrees without requiring its students to meet educational standards for such degrees established and traditionally followed by reputable institutions."  (U.S. Office of Education, March 1974). "Degree mill" and "diploma mill" are used synonymously.

 

The Problem

The laudable increased interest in health and nutrition on the part of the public is being exploited by unqualified "nutritionists" advertising themselves as "consultants" or "counselors."  In reality, such people are salespersons with spurious credentials obtained through diploma mills or certification mills.

The State of California has become an unwitting partner in aiding nutrition quackery by permitting diploma mills to operate legally within its borders.  Although legislative reforms have been undertaken, institutions continue to operate and grant academic degrees in California under section 94310 (c) of the revoked state education code.  This legislation established a legal loophole which gave anyone with $50,000 in assets the opportunity to sell any academic degree he/she wished without providing any assurance of academic standards upon which the state could evaluate the integrity of such degrees and terminate a degree program that was judged to be substandard.

What is being taught at most, if not all, of these state "authorized" diploma-mills can be categorized as pseudoscience and food faddism.  This is evidenced by the fact that at least some of the "faculty" or "academic" advisors at several of these schools have criminal convictions in the area of health fraud.  The "textbooks" used at most, if not all, of these "schools" can usually be found on the shelves of health food stores, apparently because they convince unsuspecting consumers to buy unnecessary food supplements.   These books invariably promote a variety of unscientific ideas about nutrition and its role in the treatment and prevention of disease.

Graduates of these diploma-mills are using their specious degrees to pose as nutrition experts in California and other states and countries.  These unqualified "nutritionists" charge unwary clients counseling fees for dubious advice; utilize unproven and disproven "tests" to assess nutritional status and determine "prescriptions"; and often profit personally from the sale of food supplements that they prescribe either by direct sales or camouflaged kick-back schemes.   Some are agents in multi-level marketing schemes for formula weight-loss programs or supplements.

Selling what you are prescribing results in an obvious conflict of interest.  Such practices are permissible under California law because (1) nutritionists are not licensed in California, making it legal for anyone to do nutrition counseling in California and (2) California law specifically allows anyone to give general advice about nutrition under Section 2068 of the Business and Profession code.

Some of California's nutrition oriented diploma-mills even have course work on how to avoid clearly violating state laws against practicing medicine without a license.  In effect, these courses teach the diploma-mill "student" how to legally profit from nutrition quackery and/or health fraud.  A diploma-mill which merely sold its "students" phony degrees while offering no instruction whatsoever would pose a less serious threat to public health.

Harm

Permitting nutrition oriented diploma-mills to train "students" in pseudoscience and nutrition quackery and grant academic degrees serves no useful purpose.   Furthermore, these institutions pose a serious threat to (1) diploma-mill "students"; (2) health consumers; and, (3) legitimate health professionals.

(1) Harm to Diploma Mill "Students"

A)  Degree mills often engage in aggressive advertising campaigns often duping naive people into taking correspondence courses and obtain degrees by mail which are believed to be equivalent to "campus without walls" types of programs offered by some legitimate educational institutions.  State "authorization" of institutions offering academic degrees but teaching nutrition pseudoscience can only serve to confuse individuals seeking a legitimate degree in nutrition.  Honest but naive individuals attending these diploma-mills are deceived about the proper role of nutrition in the treatment and prevention of disease.

B)  Graduates of these schools become instruments for the highly profitable food supplement industry.  Having been misinformed about the demonstrated value of food supplements at "school" they can easily be lead to purchase nutrition products which have not been shown to be safe or effective for their personal use.

C)  Graduates of these schools are often discouraged from seeking health care from qualified providers because what is taught at diploma mills generally conflicts wit h scientifically based information.  Failure to seek appropriate health care for a serious health problem may lead to needless suffering or even death.  Even delaying the seeking of effective health care may have dire consequences for misguided diploma-mill graduates.

(2) Harm to Health Consumers

The kinds of harm which can befall consumers can be placed in five categories: economic, direct, indirect, psychological and societal.

A) ECONOMIC HARM:  Economic loss occurs to health consumers who consult with diploma-mill nutritionists because, in many cases, they will have paid good money for worthless tests, inappropriate advice and usually ineffective food supplements. Such costs can be substantial when a single test may run as high as $750 and the bill for unneeded supplements may amount to a hundred dollars more per month.  In some cases these diploma-mill nutritionists conspire with unscrupulous and/or misguided licensed health professionals to attain coverage of their nutrition counseling services thereby increasing the cost of private and state paid health insurance plans for all health consumers.

B) DIRECT HARM:  Misguided nutritionists often prescribe dangerous megadoses of vitamins or minerals that can interfere with the action of prescription drugs and/or cause toxicity, birth defects, or malnutrition.  Herbs, some of which contain potent pharmacological agents, are often utilized by unqualified nutritionists lacking knowledge of pharmacology or pathology.  Such can lead to serious health problems.

Poorly formulated weight-loss concoctions may be promoted with no more than the biased promotional material supplied by manufacturers to guide the unqualified nutritionist.

Other potentially dangerous items such as bee pollen which is highly allergenic, raw milk which may contain dangerous salmonella, glandular supplements which may contain powerful hormones or be contaminated with pathogenic organisms such as E. coli, lead-contaminated bone meal tablets, an so forth are likely to be sold by misguided nutritionists educated by degree mills.

C) INDIRECT HARM:  Health consumers may also be harmed by the omission of appropriate advice on nutrition, an inability to recognize when medical help is needed, or by the fact that many diploma-mill nutritionists discourage their clientele from seeking the counsel of legitimate health care professionals.  Some of the individuals connected with California degree mills are known promoters of questionable cancer cures (e.g., laetrile) which divert patients from conventional cancer therapy to unproven "nutritional" regimens which can result in needless suffering or death as wasted time turns a curable cancer into a fatal prognosis.

D) PSYCHOLOGICAL HARM:  A persistent message found among unqualified nutritionists is a disdain for conventional scientific health concepts and practices.  The negative philosophy of food faddism says that "orthodoxy" cannot be trusted.  This theme is the basis for the existence of a "health foods" industry that is separate from the regular food industry.  This negative theme is used to justify the so-called "alternative" methods taught by the degree mills.  This irrational theme of distrust is the critical factor which turns the curable patient into a victim of dangerous quackery.  Sadly, many of the victims are children who's parents have been deceived by the cynicism or paranoia common to misguided practitioners.

E) SOCIETAL HARM:   In a democracy, when large numbers of people believe wrongly, society at large can suffer.  The unfounded belief that "junk foods" can cause aberrant behavior led to an unjust verdict in the infamous "twinkie defense" incident in California.  Bad public policy, misdirected research efforts and more can result from the proliferation of nutrition pseudoscience.

Degree mill graduates help to institutionalize nutrition misinformation when they are legitimized by the state.

Sometimes graduates of diploma-mills use their spurious degrees to pose as experts on TV and radio talk shows.  Others use their phony degrees in the print media to lend credibility to articles they write promoting nonsense food supplements which they are frequently selling.  Such appearances serve to increase the public's perception of diploma-mill nutritionists as experts while undermining the efforts of responsible health professionals to use the media to educate the public about sound nutrition principles.   The promotion of nutrition quackery in the mass media seriously undermines the efforts of responsible health professionals to promote scientifically valid nutrition principles.

  1. Many people have altered their diets inappropriately or started taking useless (and sometimes harmful) food supplements after hearing or reading the pronouncements of a diploma-mill nutritionist on TV or radio or in the print media.
  2. Producers of TV and radio shows (especially the "talk" variety) tend to judge potential guest primarily on their entertainment value and rarely check their credibility in the scientific and clinical community.
  3. The authors of several best-selling books on nutrition received their "education" at state "authorized" diploma-mills in California.   In some cases these publications are used as "textbooks" to train more diploma-mill nutritionists in quackery and pseudoscience.
  4. Even when the dubious nature of a guest's credentials are brought to the attention of book and magazine publishers and TV and radio producers, they frequently choose to ignore or overlook their guests diploma-mill credentials (often claiming that they cannot differentiate between bonafide and phony nutritionists).
  5. The public is more likely to take seriously the pronouncements of a "nutritionist" appearing on TV, radio or in the print media if he/she is introduced as "doctor" or has a PhD after his/her name.

Consumers Have Little Recourse to Recover Losses

Health consumers victimized by diploma-mill "nutritionists" have little legal recourse if they try to recover their financial losses. The reasons for this are as follows:

  1. The nutritionist's degree, while spurious, is legally recognized by the state of California.  At this time, no law exists that would prohibit someone from using such a degree to misrepresent his/herself to the public as a nutrition expert.
  2. Under current California law anyone can legally give advice on nutrition and diet (section 2068 of the Business and Professions code).
  3. There are no licensing laws in California which restrict the practice of nutrition counseling to only qualified individuals with appropriate academic and clinical training.
  4. Since nutritionists are not licensed in California there is little legal basis for determining what might constitute malpractice. Without licensure it is practically impossible to establish a legal standard of practice upon which a determination of malpractice could be made.
  5. Current California law seems better designed to protect the interests of unscrupulous promoters of nutrition quackery than health consumers.

(3) Harm to Legitimate Health Professionals

A)  Allowing diploma-mills to grant academic degrees in nutrition undermines the integrity of similar degrees earned in nutrition and related fields at accredited institutions. This occurs primarily because the public perceives nutrition experts as disagreeing about practically everything and, therefore, finds it difficult to believe anyone who claims to be a nutrition authority.

B)  The proliferation of diploma-mill nutritionists with authentic-appearing academic degrees in nutrition seriously undermines the efforts of responsible healt h professionals to encourage people to adopt healthier dietary habits.

  1. Dietitians and other health professionals are forced to spend more and more of their patient contact time debunking the unsubstantiated claims made by pseudo-nutritionist with authentic appearing credentials.
  2. Many health consumers view individuals with PhDs in nutrition from diploma-mills as better qualified than registered dietitians and physicians at assessing a patient's nutritional needs.  This can undermine patient care in hospitalized patients who often refuse to abandon inappropriate diets and supplements even when they are informed that they are compromising their health care.

Toward A Solution

Even if the new state regulations for California's "authorized" institutions eventually closes the doors at all of these nutrition oriented diploma-mills the problems created by these "schools" will not cease because:

  1. Most of California's state "authorized" diploma-mills operate primarily by mail and could easily relocate in other states which do not prohibit unaccredited schools from granting academic degrees. Nothing in California law prohibits individuals who attain their diploma-mill degrees from other states (or countries) from using these degrees to pose as experts in California.
  2. California already has thousands of "home grown" diploma-mill nutritionists. One of these "schools" claimed to have "an active enrollment of some 3700 students" in 1983. In addition to these, there are a number of others residing in California wit h phony degrees from other states and countries. Merely prohibiting diploma-mills from granting academic degrees in the future will do nothing to solve the threat to public health from these "preordained" phony nutritionists.
  3. SB2051 - Legislation which repealed this section of the state education code gave the Private Post secondary Education Division (PPED) [formerly the Office of Private Post secondary Education] the authority to establish standards and regulate degree granting state authorized institutions in California. These regulations went into effect on July 1, 1985. Whether or not these new regulations for state authorized institutions will put all of these diploma mills out of business remains to be seen. Since there are over 180 state authorized "schools" currently operating in California, it may be several years before all of them have been evaluated by the PPED.

Recommendations

The NCAHF recommends the following actions to correct the problems created by nutrition oriented diploma-mills and their graduates.

1) All states should enact laws that assure that degree granting institutions within their borders award degrees based on sound educational standards. In academic fields the NCAHF believes the accrediting organizations recognized by the U.S. Department of Education should establish those standards.

2) All states should enact laws which would prohibit individuals with academic degrees obtained from unaccredited institutions from using these degrees to misrepresent themselves to the public as nutrition experts.

3) All states should enact laws that would specifically prohibit the use of diploma-mills degrees in the mass media.

4) All states should enact laws that prohibit unqualified individuals (with or without phony credentials) from doing nutrition counseling.

5) In the absence of such consumer protection legislation, health consumers should be encouraged to view with extreme skepticism the nutrition advice from individuals with degrees in nutrition from unaccredited educational institutions. Consumers are advised to check out the accreditation status of any degree granting institution unfamiliar to them. This may be done by telephoning the registrar's office in any accredited college or university nearby. Consumer may also verify a nutritionist's credentials by checking with the local or state dietetic association, nutrition program within the public health department, nutrition department of an accredited school, local Dairy Council, USDA Extension Service, or NCAHF.


Please retain the following notice on any copies made of this position paper:

The National Council Against Health Fraud, Inc.

NCAHF is a private nonprofit, voluntary health agency that focuses upon health misinformation, fraud and quackery as public health problems. Its funding is derived primarily from membership dues, newsletter subscriptions, and consumer information services. NCAHF's officers and board members serve without compensation. NCAHF unites consumers with health professionals, educators, researchers, attorneys, and others who believe that everyone has a stake in the quality of the health marketplace. NCAHF's positions on consumer health issues are based upon principles of science that underlie consumer protection law. Required are: (1) adequate disclosure in labeling and other warranties to enable consumers to make proper choices; (2) premarketing proof of safety and efficacy for products and services that claim to prevent, alleviate, or cure any disease or disorder; and, (3) accountability for those who violate consumer laws.

For more information, write: NCAHF, P.O. Box 1276, Loma Linda, CA 92354-1276; Fax: 909-824-4838. Donations to NCAHF are tax deductible under IRS tax code 501 (c)(3).

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