In a previous article published on Foodthink, “Have Dietitians Become Food Giants’ ‘Lackeys’? A Registered Dietitian’s Perspective”, we exposed how food companies in North America sponsor influential dietitians and industry organisations, using plausible-sounding science communication to shape public perception of food. China faces similar issues: health supplement and food advertisements proliferate online. How do dietitians themselves view commercial collaborations? And what role should professionals play in a media landscape that is a mix of the reputable and the dubious? Read on for Zheng Luyue’s response, shaped by interviews with dietitians from different backgrounds.As host of the podcast “Ba Jiu Bu Li Shi” (podcast), I frequently receive invitations in my business inbox to endorse health supplements, mostly from local “niche” brands — I have even been approached by frozen-food companies seeking my endorsement. Being courted gives me a subtle sense of validation, but for me, promoting health supplements would compromise the independence of my science communication. The back-and-forth on WeChat just to establish whether a product is genuinely safe and reliable is simply too costly in time and effort. So I choose to guard my reputation, politely decline, and joke to friends: My podcast literally talks people out of buying popular supplements — and yet these brands still think I can sell them?● A business collaboration invitation I received from a nutritional supplement brand.
Although I have not yet accepted a single health supplement endorsement, in the free market of media, companies can always find collaborators willing to compromise, and quite a few top-tier dietitians in the industry choose to work actively with commercial brands.
Should dietitians accept commercial endorsements? Where is the line between brand promotion and science communication? Are dietitians who hold firm to their principles, in fact, a minority in the profession? Armed with these questions, I conducted a small survey among my dietitian friends.
● Virtually every nutritional and health supplement brand recruits large numbers of doctors and dietitians for endorsements and promotion. “Endorsed by 100 dietitians” has become a stock marketing phrase for some food companies. Image from the internet.
I. Who Regulates Commercial Misconduct?
Before laying out what dietitians themselves say, we need to clarify one thing first: who is responsible for overseeing dietitians’ commercial conduct? In the United States, the bodies that regulate dietitians are the Federal Trade Commission (FTC) and the Academy of Nutrition and Dietetics (AND). The former, a federal government agency, monitors commercial practices, combats false advertising and improper marketing, and protects consumer rights. The latter is a national professional body representing the industry — akin to the Chinese Medical Doctor Association — and plays a major role in dietitian certification, continuing education credits, and the setting of professional standards.
Chinese policy has long opposed qualified physicians endorsing commercial products. From the 2022 crackdown on “livestream product selling by medical personnel exploiting their professional positions” to the 2024 call to “strengthen oversight of medical-related livestream commerce, content, and broadcasting order,” the National Health Commission (NHC) and thirteen other ministries have been closely watching pseudo-science communication in the health and medical sector.
While platforms assist in managing violations such as illegal traffic redirection, self-media creators have also learned to self-censor, proactively avoiding prohibited terms under the Advertising Law — for example, “most,” “best,” “cure,” and “safe.” China’s Advertising Law explicitly stipulates:
Advertisements for medical services, pharmaceuticals, medical devices, and health food products must not contain “assertions or guarantees of efficacy or safety” or “use an advertising spokesperson to make recommendations or attestations”; radio stations, television stations, newspaper and audiovisual publishing outlets, and internet information service providers must not publish advertisements for medical services, pharmaceuticals, medical devices, or health food products in disguised forms such as health or wellness knowledge content.Despite increasingly tight legal and industry oversight, monetising health-related knowledge still operates in grey areas. Current regulations do not clearly distinguish between “commercial promotion” and “advertising,” allowing health supplements to slip past oversight in livestream rooms — marketing in the guise of science communication. Meanwhile, the prevailing professional norm holds that “physicians must not use their profession, official position, or hospital name, nor sell products on hospital platforms.” Yet this red line implicitly assumes practitioners remain within the hospital system. When health content creators step outside the constraints of their employer, the ethical boundaries grow blurry. For instance, if a doctor appears on camera in a livestream but refrains from commenting on the product, does that constitute an endorsement? If a dermatologist sells health supplements on livestream, is that professional overreach? None of these questions has a definitive answer.
By comparison, the medical profession has had more thorough discussions of conflict of interest and has developed more mature codes of conduct. China’s registered dietitian system, launched in 2017 and still in its infancy, lacks any ethical guidelines on commercial collaborations or endorsement activities, making it all too easy for a dietitian’s decision to take on advertising to slide into a purely financial calculation. With conflict of interest seldom discussed within the industry and little enforceable constraint, curbing “pseudo-science communication” comes down to individual conscience.
What makes matters more tangled is that the very title “dietitian” has yet to form a clear public understanding. From “registered dietitian” and “dietetic technician” to “Public Nutritionist” and “nutrition guidance worker,” the titles are numerous and the professional thresholds vary widely. Some internationally certified dietitians have even been exposed as holding fraudulent credentials.
● The bewildering array of “dietitian” professional certificates and titles found online. Although “registered dietitian” carries the highest value in China, ordinary people cannot tell who is genuinely credible.Admittedly, the US Registered Dietitian (RD) credential I hold places greater emphasis on applicants’ theoretical knowledge and hands-on experience (requiring a master’s degree as the entry standard, more than 1,000 hours of supervised practice, and continuing education credits), and includes “disclose all potential conflicts of interest” in its code of professional conduct. But even so, non-compliant commercial endorsements still exist within this group. It is a reminder: without the hard force of law, even the best codes of conduct risk becoming empty words; and when profits are at stake, professional boundaries are often more fragile than we imagine.
II. In Favour: What’s Wrong with Dietitians Taking Ads?
Should dietitians engage in commercial collaborations? Views within the profession are sharply divided. Whether considered from a dietitian’s personal standpoint or the industry’s perspective, accepting commercial partnerships has its upsides. On one hand, such collaborations can help address dietitians’ livelihood concerns; on the other, they can raise public awareness of the dietitian profession through self-media platforms, bolstering dietitians’ sense of professional worth.
For example, a registered dietitian working in a hospital put it candidly:
“If I were still back in my student days, I would have felt absolute contempt for this kind of behaviour — taking ads and publishing statements that deliberately steer consumers. But now that I’m in the workplace, dietitian is a very low-paying profession. Under the pressure of making a living, I cannot support such actions, but I fully understand them. Only by giving this field more recognition and respect, and raising salaries, can we expect those who trained formally in this discipline to stay true to themselves.”Another registered dietitian who previously vetted sponsored content for a company said:“I genuinely think this — the sponsorship arrangement — is a good thing, because it is a two-way choice. Not every dietitian is willing to do this, or capable of doing it… They (the dietitians in the collaborations) will cross-check the (promotional) script with our (content) team. If they feel they cannot say a particular line, they will strike it out. …Personally, I think it’s quite wonderful, because I couldn’t earn that kind of money myself [laughs] — it’s not that I think people saying this (collaboration) language are betraying their conscience… I’m far too squeamish to be an influencer… So I’m rather envious, or rather, I genuinely admire the people who can speak fluently off the cuff, delivering lines that are ‘dangerous, captivating, and yet within bounds.’ On the other hand, I feel that companies, especially the big brands, can also bring some visibility to the dietitian profession.”At the same time, I noticed that dietitians who are active on self-media platforms tend to hold a more positive view of commercial collaborations. In our discussions they also stress the benefits such partnerships bring to the public — for instance, helping consumers choose products.
III. Against: Under Commercial Logic, Professional Integrity Is Easily Lost
Whether one is for or against commercial collaborations is often less a matter of attitude than of circumstances. Dietitians who do not rely on monetising traffic tend to hold more firmly to professional ethics.One registered dietitian, drawing on her perspective and experience as a self-media creator, reflected on the difficulty of balancing traffic, sponsorships, and professionalism:“When I was first building up my follower count, I set myself a rule: I would not take on any dietary supplement advertising, or any advert that conflicted with my (nutritional) philosophy. Although I have had some genuinely pleasant collaborations, most of the invitations have come from products that walk the line between healthy and unhealthy — probiotics, for instance, or so-called health drinks. The entire commercial collaboration involves a lot of back-and-forth wrangling. The selling points some brands want to push are precisely the claims that make my stomach drop and that I want to steer clear of in the promotional copy. Once I started working full-time, my own time shrank considerably, and I began to reflect: do these commercial collaborations bring me more joy, or do they simply pile up frustration and drain me? Now I focus more on food-related content that does not require me to offer a specific endorsement on the nutrition front. …Even if there are products or claims where you could find some study to lend support, if my conscience does not buy into them, forcing myself to give a dietitian’s endorsement feels genuinely painful.”Overall, in a commercialised market environment, dietitians who choose the self-media path face steeper survival pressures and greater challenges to professional ethics. Much like doctors who opt into livestream product selling, many dietitians are not unaware of the value of standing by one’s principles; rather, their career prospects are limited and financial pressures loom large. Especially for practitioners outside tier-one cities, where job opportunities are scarce, resolving income shortfalls through commercial partnerships can be an extraordinarily tempting option.● A hot topic about dietitians on self-media: “How dietitians can monetise through self-media.” Image from the internet.It is precisely through the profession’s structural weaknesses — unclear industry standards, declining public trust, and imbalanced income structures — that capital continues to expand its influence.
IV. Whom Should We Trust Inside the Filter Bubble?
Whatever dietitians choose, one thing is beyond doubt: “pseudo-science communication” designed to serve commercial promotion is rampant across the internet today. A registered dietitian friend, after reading Companies Buy Off Dietitians, remarked:
“Algorithm-driven feeds often trap people in filter bubbles, feeding them content that is both narrow and heavily biased. When so-called ‘experts’ keep reinforcing that content, consumers’ room to choose is not only compressed — it can be actively manipulated.”I feel a similar sense of helplessness in everyday life. My family members could simply ask me — a genuine registered dietitian — yet they are often drawn in by “wellness videos” or “influencer doctor recommendations.” Sometimes, no matter how many times I explain, I struggle to fully counter the influence of that pseudo-science. Piao Jingxuan, another US Registered Dietitian (RD) active on self-media platforms, is more direct:
“As a dietitian, much of my job is ‘busting myths.’ So many patients bring headlines they have seen online and ask, ‘Is this true?’ More often than not, they are sensational, taken-out-of-context clickbait headlines.”In the comments section of an article about doctors doing livestream product selling, I once came across a scathing remark:“Legitimate doctors are banned from livestreaming, and their content gets pulled down — yet these charlatans get to don a doctor’s disguise and peddle misinformation brazenly. Why fill livestream rooms with fake doctors?”Though the tone is fierce, it voices the public frustration beneath the ban on “physicians selling products” — the feeling that the professional image of doctors is being exploited. Dr Jiang Qianzhi, a US Registered Dietitian (RD), offered a similar comment:
“Setting registered dietitians aside, there are plenty of influencers and celebrities who claim to be nutrition professionals or have no scientific background at all, already cashing in on their fame and influence in this space. I would much prefer to see registered dietitians doing this work — at the very least, most dietitians screen products and make recommendations based on science and professional ethics.”This struck a deep chord with me. When I heard a culture podcast I follow deliver a sponsored read for a health supplement brand I had once declined to work with, I felt every emotion at once. In that moment, it felt as though someone was sneering at my steadfastness: “If you won’t do it, someone else will.” Perhaps, for many self-media creators who are not dietitians by training, taking a health supplement ad carries far less psychological weight. They may not, as I can, look through the literature, interpret the data, or assess the quality of evidence. And it is precisely because of my academic and clinical training, and because I identify with the professional ethics of dietitians, that I simply cannot learn to play both sides. On the scales between traffic and professional integrity, I choose to place my weight on public-interest podcast content that upholds professional standards, rather than on the short-term returns of monetising views.
I am fully aware that one dietitian’s refusal cannot hold back the flood of commercial endorsements. Commercialisation is not an original sin. In truth, I also enjoy using my expertise to speak up for books or products that are genuinely worthwhile. I simply wish that when we talk about “endorsements,” we would also talk more about transparency and discuss conflicts of interest more openly. If every dietitian recommendation were underpinned by professional principles, perhaps the waters of science communication would not be so murky that people cannot tell truth from fiction.
For genuinely public-interest, responsible content to reach more people, we also need a kind of positive incentive — one that gives professionals the motivation and the mechanisms to produce high-quality content, rather than forcing them to be torn repeatedly between conscience and livelihood. Only by creating a virtuous cycle, in which those who hold to professionalism and ethics are not penalised, can public-interest content truly stand out in a commercial landscape. As a professional who has long been involved in public policy advocacy put it:
“In an environment like this, the voices of professionals, professional societies, and public-interest organisations who actively steer clear of corporate inducements are all the more precious.”
V. Consumers: How to Build Your Judgement?
As for consumers, how should they distinguish genuine science communication from commercial endorsement? In an age of information overload, nutrition knowledge is not in short supply; what is lacking is a set of tools and habits to help us exercise judgement. Building that judgement is the most effective vaccine any individual can take against “pseudo-science communication.” First, consciously cultivate your “information immunity” — learn to recognise the rhetoric of product promotion. When confronted with topics involving nutrition, wellness, or medicine, stay alert: do not take words like “miraculous results,” “instant effects,” or “ancient family recipe” at face value, and you will sidestep most pseudo-scientific claims.
Another common mislead: conflating correlation with causation. For instance, “people who eat this food live longer” — but perhaps they also exercise regularly, keep to a consistent routine, and eat well in general. A being associated with B does not mean A causes B. This sleight of logic is the easiest way to get people to part with their money without thinking twice.
Second, seek out content creators whose professional credentials are clear and whose sources are transparent. People with genuine qualifications — registered dietitians, licensed physicians — are usually more trustworthy than “health influencers.” You can also follow official accounts run by public institutions, hospitals, or professional societies.
When someone casually says “the product is backed by data,” ask yourself: what data, exactly? Which study? Who was studied? And how did the conclusion leap to the bottle of health supplement sitting on your shelf? “Harvard recommended,” “internationally certified,” “anti-inflammatory superfood” — these buzzwords sound impressive, but they are no substitute for scientific evidence. A truly credible recommendation can explain the mechanism and cite the source, rather than stacking keywords to manufacture an air of expertise.
Third, watch for potential conflicts of interest. When a piece of content features a specific product, ask yourself: “Does this person have a partnership with the brand?” Even without a disclosure, an overly salesy tone warrants caution. You can also ask directly in the comments: Is this a paid promotion? Is there a financial relationship with the brand?
Finally, return to the simplest principles of everyday health — a balanced diet, a regular routine, and moderate exercise. These tips may sound like platitudes, but they are the most time-tested dietary guidance there is.
Foodthink AuthorZheng LuyueUS Registered Dietitian (RD), doctoral student in Nutrition Science at the University of New Hampshire. In recent years, exploring the livelihoods of small-scale farmers in New England, USA, under the guidance of her sociology supervisor. She dislikes eating alone and updates two podcasts on a flexible schedule (@八九不离食, @悦食谈).