Patricia Daly NT, a fully qualified Nutritional Therapist and full time member of NTOI has been regularly criticised in national media and in numerous private social media publications over the past year as a result of releasing a cookbook, as well as conducting talks and private consultations regarding the use of Ketogenic diets in people dealing with cancer.

The criticism is mostly coming from Dietitians who, with the supposed aim of ‘educating’ the public, argue that Nutritionists are unqualified to offer nutritional advice, particularly to people with chronic medical conditions. This criticism is potentially valid given the fact that the term Nutritionist or Nutritional Therapist (NT) is not yet a legally regulated title in Ireland (or the UK) therefore anyone could conceivably call themselves an NT without breaking any law. Indeed some people are calling themselves Nutritionists and offering advice to the general public despite having no formal training, no peer review process and no oversight. This is an unfortunate but real situation which could genuinely pose a risk to vulnerable members of the public.

However, in the confusion it is important for members of the public, as well as for Dietitians, to realise that NTOI is the professional registration body for fully qualified Nutritional Therapists in Ireland and ALL of its full members have demonstrated core competence in individualised nutritional care as per the same criteria set by The Nutrition Therapy Education Commission in the UK. Therefore being a member of NTOI means one is qualified to offer nutritional advice to the general public, including people with chronic medical conditions (but excluding acute life threatening cases).

Having reviewed much of the criticism, as well as Mrs Daly’s approach to diet therapy in, amongst other cases, cancer, the NTOI committee would like to state the following:

Accepting that adjunctive dietary support for cancer sufferers requires a high degree of knowledge, respect and cooperation with primary oncology care givers, we are confident that Mrs Daly approaches her work in a professional manner consistent with this complex area.

She regularly consults medical experts and attends leading edge continuing education events to stay abreast of current opinion on the subject and is in no way acting irresponsibly in her online service promotion nor in her delivery of dietary advice to clients.

In addition Mrs Daly provides detailed group education and direct individualised support to numerous clients worldwide, both with and without cancer, concerning the implementation of the Ketogenic Diet.

Much of the aforementioned criticism centres around the valid concern that restrictive diets, if implemented incorrectly, carry a real risk of unwittingly inducing frank nutrient deficiencies.

However we are fully satisfied that Mrs Daly’s advice is comprehensive and grounded in sound science and particular care is taken to avoid the pitfalls.

Although one might properly refer to the Ketogenic diet as extreme, this work falls within the boundaries of NTOI members remit to provide individualised diet support and we are confident that Mrs Daly is actively and professionally ensuring her clients are properly advised on the implementation of this difficult diet in a way that poses no risk of inducing the kind of frank nutrient deficiencies otherwise associated with uninformed implementation of a restrictive diet.

The NTOI committee does accept the ever present threat of random individuals misinterpreting sound advice and in doing so unwittingly placing themselves at risk, however this situation applies to all professional advice, and all professions do their best to minimise its occurrence by being as clear as possible.

We feel that whilst valid concerns are being raised about the potential mis-implementation of diet advice in cancer cases, the extent of the personal attacks on Mrs Daly are bordering on harassment and the content of much of the criticism is generic in nature and uninformed with regard to any specific cases Mrs Daly is working with. To our knowledge no individual client has lodged a complaint or reported Mrs Daly for any misconduct. Indeed she regularly receives positive feedback from a diverse array of oncology professionals.

We also welcome discussion on the evolving subject of nutritional ketosis but are concerned that the level of vitriol and personal attacks on Social Media are clouding the field and preventing productive debate from happening and call on all people involved to be professional and cognizant of the need to remain open minded on complex subjects given the deep need of so many people who look to us for guidance during trying times.

Sincerely
NTOI Committee.