I’ve often said that “cancer woo” is the worst “woo.” That is, the crazy, totally untested theories often sold by charlatans as cancer treatment. I’ve personally experienced people pushing unfounded advice and therapies to patients at their most vulnerable. And the topic obviously touches food production. So I was really excited to meet Danielle Penick and learn about her work with Survivor’s Table. Danielle is a Registered Dietitian who specializes in cancer nutrition. I chatted with her about her work and why it’s so important.
What interested you about being a Registered Dietitian?
Originally I wanted to be a pharmacist. During high school, my first job was working in the photo department at Walgreens. One day I had an opportunity to fill in as a cashier in the pharmacy during a few busy holiday’s and learned I really enjoyed the medical field. The next year I started college at Florida State University and at the time they didn’t have a pharmacy program. After realizing this would eventually require me to transfer schools I started looking into other programs. This was partly because a scholarship awarded to me was to be used for medical field professions only and I didn’t want to forfeit the assistance.
After looking through a limited number of majors I stumbled upon the word dietetics and had no idea what that word even meant. Once getting a better idea of what a dietitian did, I thought that I might enjoy it since the profession was based around helping others. What interested me the most was how versatile the profession was. You could be a clinical dietitian, a community dietitian, have your own private practice, become a researcher or professor (with additional training), or you could even become a sports dietitian. I took my first class and fell in love with the field! It’s been 10 years and it’s still my passion.
So are Registered Dietitians given training? Or can anyone with a blog become one?
You certainly would think almost anyone with a blog, book, or a website is a credible resource to give nutrition information, but unfortunately that is not the case. Just about anyone can call themselves a health coach or a nutrition expert, but a Registered Dietitian is given much more rigorous training. We are required at minimum to obtain a bachelors in dietetics (and now our field is moving towards requiring a masters degree soon) and complete a 1200 hour internship. Then internships are quite competitive and just around 50% of those who apply get one. Only once our internship and schooling is completed can we sit for a national board examination. And once we pass the board certification, only then can we call ourselves a Registered Dietitian.
It’s really confusing when you hear the term nutritionist as well. Registered Dietitians can call themselves nutritionists, but the opposite is not always true. It’s really important to make sure the advice you are getting is not from someone who hasn’t had much training, if at all.
I’m sure people are a bit nervous about eating around you? So do you actually judge what people are eating all the time?
Oh I absolutely make people nervous when they eat! Dietitians are often called the “food police”. But we are people too. Every once in a while I like to indulge in a treat and think quality of life is important. It’s really all about balance because never allowing yourself an occasional treat isn’t a sustainable lifestyle for most. I like to think of registered dietitians as food resources instead of food police We’re really just here to help.
Quite honestly when I’m selecting my own meal I’m typically more focused on what I’m going to eat than what the person next to me is eating. Occasionally I want French fires or a desert and I certainly don’t want people judging me!
I’m really interested in your work with Survivors’ Table. Can you tell folks what that’s all about?
Survivors’ Table is an online resource for cancer survivors, which connects people to evidence based information on cancer nutrition and health. It’s probably one of my proudest accomplishments and I created it for a handful of reasons. The biggest being that my Aunt Sherry (who I was very close with) passed away from breast cancer in the early 2000’s. She was a big inspiration to me. After she passed away, I started my career in oncology nutrition and my blog many years later, but I think supporting cancer patients would have made her really proud.
Another big reason for creating this resource is that every week in my work as a dietitian I hear about a new diet or supplement from patients that sends me searching many journal articles and science based resources to fact-check the details. Combing through this information can be time consuming and sometimes difficult even for me as a health professional. I realized how much more overwhelming it is for someone newly diagnosed with cancer who doesn’t have a background in health or nutrition. Patients also often don’t have a lot of time to heavily investigate research articles or what is actually a reputable resource with all of their appointments and managing their healthcare—that in and of itself is a full time job. It inspired me to create a go to site for cancer survivors to obtain evidence-based information since there is such an abundance of suspect nutrition recommendations out there.
Probably my most personal motivation for creating Survivors’ Table was to work through my own questions about best practices for cancer nutrition and, hopefully, provide information that is useful for cancer survivors. And as a confession, I’ve never been a strong writer. In fact my writing has always embarrassed me. I really wanted to fix that and realized one of the few ways to get better is to have a captive audience. My hope is that people will also find my information useful and save them time.
My family has been touched by cancer. It was so frustrating when people approached us with ridiculous suggestions about alternative medicine and cure-all products. Do you find those suggestions for cancer patients and food?
I’ve also had several family members affected by a cancer diagnosis and was approached with many questions such as if juicing cured cancer, to if eating all organic cured cancer, or taking some specific supplement regimen or diet protocol instead of conventional medicine. A significant amount of my patients also have these types of suggestions from others or ask about these alternative therapies.
A cancer diagnosis can be quite scary so it makes sense when people want to do everything they can do if it could help. Cancer therapies also can sound scary. This often leads many to seek out information on their own and usually friends or family members are right there at the front lines helping with personal advice from what they have read, found online, or heard from a friend. But there is really a LOT of suspect information out there and often it’s not harmless information.
I know people generally mean well and don’t realize their information could be causing problems, but it can. For example, recently a study came out and found that those who choose alternative medicine in place of conventional cancer treatment had a 2.5 fold increased rate of death. I actually had a chance to interview one of the lead authors on the paper, Dr. Skyler Johnson. I refer people to his study and our interview often.
Alternative medicine often seems less intimidating and can certainly have its appeal. It doesn’t help that marketing and personal anecdotes can be extremely convincing even if they aren’t evidenced based. Humans are story tellers and stories captivate us. But alternative medicine is either medicine that has been disproven to work or has yet to be demonstrated to work by rigorous scientific research. So really it’s a gamble with your health. Some of these therapies one day could be medicine or more likely you could choose an alternative therapy that doesn’t work to forgo a proven therapy that is known to work and be negatively affected. And that’s what conventional medicine is—its medicine that’s been demonstrated to work by extensive research. I mean don’t get me wrong, diet is powerful, but no single diet or supplement protocol can cure cancer unfortunately. There’s strong evidence for diet and cancer prevention, however.
It’s really interesting that we live in a time where we have more access to health and nutrition information than ever before. Yet, paradoxically, there seems to be even more confusion about health and nutrition than there has been in the past. So reducing your risk of harm is why it’s so important to really make sure you are getting reliable information. It can be really hard to tell the difference, but there are some good resources out there.
About Danielle: Danielle Penick is a writer, a registered dietitian who practices in Phoenix, AZ, and is one of the admins for Build Up Dietitians. Danielle is also the creator of Survivors’ Table, an online resource for cancer survivors, which connects people to evidence based research on cancer nutrition and health. For updates, you can follow Survivors’ Table on Facebook.