Dietitians welcome the public’s improving knowledge about food and nutrition but urge us to seek professional medical support before self-diagnosing potentially serious conditions and cutting out major food groups.
Dietitians have growing concerns about the number of people eliminating food from their diet after self-diagnosing serious dietary problems for themselves and their family, without seeking any medical intervention.
In a survey by YouGov and the British Dietetic Association (BDA) over 2,000 people in Britain were asked what, if anything, they have self-diagnosed when it comes to issues relating to food and nutrition. 49.5% confirmed they or a family member believe they have had a condition relating to what they eat, without having any investigation or advice from a healthcare professional (such as a GP or dietitian).
The survey revealed the most common self-diagnosed condition is Irritable Bowel Syndrome (IBS), with 20.2% saying they or a family member suffer from it. This is followed by a vitamin or mineral deficiency (15.9%), a food allergy - such as shellfish or eggs (9.9%) and an intolerance to lactose (9.6%).
51.2% of all of those surveyed say that when looking to self-diagnose a condition they get their dietary and nutritional advice from an internet search engine. Providing they are looking at reliable websites, from the likes of the NHS and those from registered dietitians, this is not of huge concern but this is often not the case.
The fear is that by only relying on generalised information they’ve read or heard or, as is becoming more common, by using an at-home testing kit, the public are going on to treat potentially serious medical conditions themselves. By cutting out important food groups without suitable alternatives and not getting what sometimes might be the critical care they need, people are potentially putting themselves and their family members at risk.
Duane Mellor, Registered Dietitian and Senior Lecturer at Aston Medical School said: “Seeking advice purely online can be risky. Search engines may offer you a range of supplements and products that you probably won’t need. They may also offer up links to advice that is not scientifically correct. It is best to look at verified health websites for accurate and evidence informed health information.
“It can be tempting to seek out the first website when you are struggling with a health condition and symptoms you feel are linked to something you have eaten. But, it is always wise to seek qualified health professionals to first diagnose it, and then a dietitian to get the scientifically accurate dietary advice, which will be tailored to your needs and likes.”
Parents in particular should get professional advice before changing their child’s diet. Cutting out major food groups can deprive a child of essential calories and nutrients, crucial for growth and development.
Bahee Van de Bor, Specialist Paediatric Dietitian and BDA Spokesperson said: “The most common thing I get told is, "I think my child is gluten intolerant" because he/she has a sore tummy after eating regular bread or pasta. Whilst parents might not be too far off from the culprit, it's really important that they don't cut out gluten before consulting with a healthcare professional.
“Instead, work with your child's doctor and paediatric dietitian, who can support you to identify the true root cause of the symptoms, as it might be different from what it initially appears to be. Cutting out gluten or wheat without medical guidance won't guarantee desired results and it can unfortunately lead to anxiety and disruption around eating for both you and your child.
“Without suitable substitutes you can potentially deprive your child of essential calories and nutrients like fibre, calcium, iodine, and B vitamins, which are crucial for their normal growth and development too. A dietitian can provide proper guidance on safely implementing elimination diets and reintroducing foods, ensuring your child's diet remains balanced and supportive of their growth, while effectively managing their symptoms.”
Elimination diets can be a risk in adulthood too, leading to potentially more health problems.
Duane added: “Even with medically diagnosed IBS it is essential to seek advice from a dietitian and not just try an exclusion diet yourself, as if it is not properly planned and supported it can put you at risk of nutritional deficiencies.”
IBS can only be properly diagnosed by a healthcare professional when other conditions, including things like bowel cancer or coeliac disease have been excluded.
Kirsten Jackson, Consultant IBS Dietitian, said: “Digestive problems are a huge taboo subject. People commonly go years without going to their doctors - if at all. IBS is also often not seen as a serious condition, so people don't feel they should see the doctor, but the reality is that it can completely ruin a person's life.”
“Many people with IBS will have or be at a high risk of developing an eating disorder, so they need professional help to navigate symptom relief without worsening their own health problems.”
Dietitians also recommend not relying on at-home allergy/ intolerance tests, involving sending off hair samples or filling in online questionnaires, to diagnose issues.
Sian Porter, Consultant Dietitian and spokesperson for the BDA said: “Dietitians understand that people want to do something to help themselves, or people they care for, and respect this. Yet it’s frustrating to know people have wasted their time and money and risked their health being given inappropriate, conflicting or one-size-fits-all information by someone unqualified, or been sold something unnecessary or unsuitable.”
Kirsten added, “There are many alternative tests available online, which can cost up to around £600, such as IGG (Immunoglobulin) tests. Many people trying to self-manage their symptoms will waste money on these tests and end up on a restricted diet, which may go on to cause nutritional deficiencies.”
The results revealed that when looking to self-diagnose, more people would listen to friends and family (23.5%) than go and see a dietitian (13.9%), the only qualified and regulated health professionals that assess, diagnose and treat diet and nutrition problems. Yet, 73.7% either strongly or tended to support the idea of having a readily available dietitian, for example at a GP practice, to be able to assess dietary problems.
Sian said: “Not seeking help from a professional could be for many reasons but certainly not understanding how to access the support of a dietitian is one. There are also many misconceptions about what a dietitian is and does - we are not the diet police and we’re not here to judge people.
“Dietitians listen and treat everyone as an individual, using our unique skills to help people with the appropriate, personalised information they need for their condition and lifestyle, saving them time, money and confusion.”
The BDA advises anyone with concerns relating to food and nutrition to ask a GP for a referral to see a dietitian. They can also use the BDA’s freelance directory to find a qualified professional to see privately.
If you are a parent and have an immediate concern about something your child has eaten, always seek medical assistance as soon as possible.
Dietitians are the only qualified and regulated health professionals that assess, diagnose and treat diet and nutrition problems, at an individual and wider public-health level. If you have any underlying health conditions or indeed simply want some dietary advice with a personalised plan that fits your specific needs we would always recommend seeking out a professional registered dietitian.