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"Training" For Health Food Retailers
One way "health food" retailers get information
is by attending national and regional trade shows where manufacturers
display their wares and various spokespeople deliver the industry
viewpoint on food and nutrition issues.
Natural Foods Expo '85 East, held October 25-28, 1985, at
the Washington, D.C., Convention Center, attracted some 4,000
retailers, most of them from the eastern United States. More
than 200 exhibits were staffed by friendly sales personnel who
passed out literature and abundant samples of foods and food
supplements. The exhibitors came from all over the country and
included many regulars from the established sister show, Natural
Foods Expo West, held each Spring in Anaheim, California. These
shows are sponsored by New Hope Communications, of New Hope,
Pennsylvania, publisher of Natural Foods Merchandiser and Delicious!
Expo '85 East featured 40 seminars and workshops covering
all aspects of merchandising, store management and industry trends.
One of the most popular seminars--which filled three hours on
the final morning--was "Nutritional Selling: A Powerful
Customer Service." Attended by more than 150 health food
store operators, it was led by Jeffrey S. Bland, Ph.D., whom
many of the participants held in obvious awe.
Dr. Bland, who is on leave from his biochemistry professorship
at the University of Puget Sound, Tacoma, Washington, has a B.S.
in biology from the University of California at Irvine and a
Ph.D. in chemistry from the University of Oregon. But much of
his aura stems from his current position as research associate
and director of the Laboratory for Nutrient Analysis at the Linus
Pauling Institute of Medicine, Palo Alto, California. Bland is
also president of JSB & Associates, Gig Harbor, Washington,
which "specializes in wellness program development and delivery."
Bland is undoubtedly the health food industry's most prolific
publicist and interpreter of nutrition-related scientific developments.
In addition to appearing frequently at trade shows, he writes
and edits books, edits and publishes a magazine (Complementary
Medicine), produces audio and video tapes, conducts courses for
professionals, and serves as a consultant to several organizations
which share the industry's views. Many of Bland's products were
available for purchase at the meeting.
Expo's nutritional selling seminar included several skits
in which Bland played storekeeper and customers were played by
three retailers: Kay Peterson, of Hazelwood, Missouri; Dale Bennett,
of Winter Park, Florida; and Peter Brodhead, of Savannah, Georgia.
Members of the audience were also invited to act as customers
and ask their "toughest question" to the four panelists
acting as clerks. The quotes throughout this article were taken
from Nutrition Forum's tape-recorded transcript, edited to remove
some of the grammatical errors, repetitious words and other minor
artifacts of speaking.
How to Avoid "Overtly Prescribing"
Much of the seminar concerned how product information might
be communicated without "prescribing" (which would
be practicing medicine without a license). One skit was set at
an "information center" located near the vitamin department
of a health food store. A 69-year-old man who is a fairly regular
customer comes in, walking considerably more slowly than usual.
He explains that he has developed arthritis and asks what he
could take to help it.
After inquiring about common symptoms such as headaches, joint
problems, intestinal problems and stuffiness of the nose, Bland
suggested that "food hypersensitivity" was a factor
and that milk, wheat and red meat might be contributing to the
man's arthritis by "aggravating his immune system."
Bland then proposed that intake of these foods be reduced and
consumption of complex carbohydrates be increased. "Fortunately,"
he added, "there are some emergent bodies of literature
and good medical studies that indicate that things like fish
oil . .. the product on our shelves over here . . . have been
shown to help stabilize the immune system in people that may
have a tendency toward arthritis." Bland also directed the
customer's attention to literature in the store so he could read
about these matters and possibly discuss them with his doctor.
Bland's reference to "emergent" studies was typical
of his presentation throughout the seminar. His delivery is rapid-fire,
with frequent use of biochemical concepts and research findings
(usually preliminary in nature) which he considers relevant and
In the ensuing discussion, Ms. Peterson remarked that although
"the Arthritis Association categorically says that food
has nothing to do with arthritis," doctors may still be
receptive to information from retailers. Bland said he would
try to make it clear to customers that he is concerned about
their medical management, that they have been seeking good care,
and that he was not practicing medicine but "trying to support
them with nutritional information adjunct to traditional medical
care." He also warned that requests for specific product
information should be handled cautiously to avoid being "nailed
With a customer who says he read about a product for relieving
arthritis pain but doesn't remember its name, Bland suggested
I'm not sure exactly what you're talking about, but I have
seen a couple of articles on amino acids like dl-phenylalanine.
Could that have been what you were referring to?
If he says yes, it is an easy lead-in to reiterate what you
learned in the article. But never say "that's what you can
take." If he says no, you can say, "Let me give you
the gist of what I read." Then you can say, "Dl-phenylalanine
was suggested as being a modulator of a substance called enkephalin
which is the body's own native pain-deadening process and that
this is a part of the endorphin family. Have you ever heard of
endorphins?" The person would say yes or no, and you can
take the conversation on like that, making it educational and
informational. That, to me, is the real position this industry
should be in. It is not diagnostic, it is not treatment, because
product sales are based on that individual's considered interest
and belief system. You'll sell more products by providing information
with less legal jeopardy than going right out and saying, "Here's
what you really should be taking on the following dose schedule,"
which is certainly overtly prescribing.
Mr. Bennett agreed: "Keep in mind that there is a very
fine line in what you can and can't say . . . Once you attach
a claim to a product, you are prescribing. So, you must teach
your salespeople that very, very carefully. Because today you
don't know who you are talking to in your stores . . . When we
talk about nutrition I don't really think we can get into too
many problems . . . We're not just selling a bottle of vitamins,
what we're selling is the concept of good health. And we can
keep hammering away at the diet."
Commenting on the abundance of helpful literature available,
Ms. Peterson said: "We must make the most of what is in
the public's mind. We're riding a wave of the education that's
out there. And we're providing a product . . . There's so much
printed information available. A few years ago, there was practically
none. Every manufacturer puts information forward. Never suggest
the number of tablets the customer should take . . . Simply read
the label instructions. Say, 'The manufacturers have recommended
this. Through their laboratory analysis, they have found this.'
Divert the information from your spoken word to some written
piece of information that you have."
The right place for advice?
The audience was then asked to act as customers and present
difficult or frequently asked questions to the panel. Here are
Customer: I've been going to a doctor and have discovered,
much to my alarm, that I have a fibrocystic lump in my breast.
I heard somewhere that vitamin E is good for helping this, and
also recently I read something about a macrobiotic diet, and
I am wondering if this is
some kind of a curative diet for my problem. I don't think the
cyst is malignant. I'd like to find some kind of way to help
myself without having some doctor cut me up.
Peterson: How recently have you been to your doctor?
Customer: Two weeks ago. I've had some time to think about
Peterson: Did they do a complete mammogram? How did they diagnose
it? Customer: No, it was just a manual diagnosis. They told me
it was the size of a small lima bean.
Peterson: You are seeking additional information, and certainly
we would like to tell you that you have come to the right place
. . . If you would be interested in changing your lifestyle--on
the basis that the way you have lived to date has not been conducive
to keeping your body free from that growth--I can show you information.
We have classes on the macrobiotic way of living, and we work
with people who teach it. The information you have come across
on Vitamin E has probably come from Dr. Carlton Fredericks' book.
I'd very much encourage you to read that so that you can also
prevent further growth. And there's a lot of information we work
with that the government has issued. One, for instance, is diet,
nutrition and cancer prevention. There is an 800 number to get
Customer: Are you saying that vitamin E does prevent further
growth of this?
Peterson: Dr. Fredericks' book addresses that issue, and I
would very much encourage you to read that.
Bland then commented:
Kay, that was a nice job. I would have probably done one other
thing myself. Because there are two types of fibrocystic conditions--one
of which is more discomfiting than it is a warning sign of cancer
-- I would have tried to get some quick information. Is this
a long-term problem? Does it come close to your menstrual cycle?
Have you had it come and go, or is it just in the last few months?
Because if it has just come on -- a lump that is not inflamed
and tender--it would be of higher order-risk for malignancy.
If, however, it's been associated with the menses, been with
her for many years, then it's probably the kind of thing Bob
London talks about in his work with vitamin E and fibrocystic
disease, lower fat diet, and so forth. You want to be very cautious
that you don't alarm the person about having cancer if there
is no need to alarm them. But you don't want to miss the possibility
that it's not a menstrual cycle-related, long-term cystic mastitis,
that it's a recent one and there is some concern about its pathology.
When another "customer" asked whether taking 50
mg of zinc might deplete his body copper level and possibly lead
to high levels of uric acid and triglycerides, Bland said probably
not and offered to look at the product's label to determine whether
the zinc-to-copper ratio was appropriate. He also suggested that
the customer read more about "ways diet relates to triglycerides
and uric acid from other avenues, such as a higher protein diet."
To another questioner he advised that sustained-release vitamins
might be advantageous because they maintain higher blood levels.
Dealing with Resistance
Several members of the audience pretended to be skeptical
Skeptic #1: Last week I kind of got carried away with your
enthusiasm and I bought an entire vitamin program that you recommended.
Then after I got home I really started thinking about it. I started
reading some publications that neighbors gave me when they saw
these vitamins that you recommended. Even such reputable magazines
as Consumer Reports said that our diet is entirely adequate,
and that they tested McDonald's and other fast foods and found
that, based on the numbers of the RDA, that B-vitamins were at
best useless and at worst can do some harm. So my question is,
how do you know what I need and can you test me? Or is there
a place I go to get tested, because I don't want to take something
without knowing exactly what my needs are.
Bennett: I can understand what you're saying because there
lot of confusion in the marketplace. I remember my clerk talking
to me about you when you had left because you had an awful lot
questions. I understand that you're an athlete, a triathlon competitor.
Well, your needs probably might be greater than a lot of other
people's needs. You're talking about some of the high-potency
vitamins that you are maybe a little afraid of. They said that
you didn't think you were getting the proper diet, that you get
up early in the morning and don't eat breakfast. What you may
want to do is just gradually work into some of these. Don't take
ten vitamins all at one time because maybe your system is not
ready for them. You may want to start with multiple vitamins
today and possibly additional C and additional E that you have
here. And after two days, maybe add this amino acid to it along
with it and try to build up. Just don't jump into it all at once.
Does that make sense?
Skeptic #1: Yes, it does. It's just a little different than
the advice I was given initially . . . The main question about
it all is basically how do I tell what exactly my nutrition needs
Peterson: There are many tests. We can channel you to some
doctors that we work with, or we have a clinical lab where you
can have evaluations done for blood, hair analysis, and we have
two doctors' offices that work with us. We'd be glad to refer
you to them.
* * * * *
Skeptic #2: My friends take vitamins, but I don't think I
need them. I eat well, exercise and get enough rest every night.
I have some stress on the job site, but I cope with everything.
Do I need to take vitamins? . . .
Peterson: Do your friends eat as well as you do?
Skeptic #2: I think so.
Peterson: Since your friends' indication that they feel better
when taking vitamins has raised the question in your mind, perhaps
you should try a B-complex when you have a stress situation arising
and see if that helps you cope better. Then you would have your
own proof. You could also read some of the books related to stress.
Mr. Bennett said he tells customers: "Genetics is very
important . . . stress is very important, pregnancy is very important.
are all reasons that we need supplements. We need probably 60
nutrients every day in our diet to totally feed ourselves properly.
Very few diets out there are accomplishing that."
Bland added that customers who question the need for supplements
can be steered toward nutrient-dense foods in the store by saying,
"That's wonderful. Do you realize we have a whole series
of good foods that can support you in your quest towards healthy
living and high nutrient intake? You're doing a great job, and
we want to reinforce it. Over here is a whole section of organic
foods. If later you have some concerns about vitamins and minerals,
we can talk about it."
When a customer asked why natural C and B-vitamins cost more,
Brodhead replied that the vitamin C in his products is made from
corn by an enzymatic process--"the same process that is
taking place internally in animals when they convert vitamin
C from blood levels of glucose." He claimed that drugstore
products may contain talc, shellac, artificial coloring, flavoring
and preservatives, and may be coated so heavily with carnuba
wax that they "completely pass through the body without
A retailer from the audience said she tells customers that
"perhaps that good diet was true in their grandparents'
time when foods were grown in soil that was nutrient-rich and
they had fewer environmental assaults. I tell them about a study
on a pig fed corn grown in Iowa 30 or 50 years ago that did well.
That same pig today would die."
When asked how to handle a customer whose interest seems to
have flagged, Bland suggested giving the customer a health appraisal
form with questions about lots of symptoms that may surface and
bring him back after he has had time to think further.
When asked whether research by Linus Pauling may show that
vitamin C can build up the immune system and make it more difficult
to get AIDS, Bland replied that Dr. Ewan Cameron and others at
the Pauling Institute are collaborating with an AIDS specialist
at San Francisco General Hospital to explore the role of vitamin
C and carnitine in AIDS. "The studies are not yet completed,"
Bland said, "but the testimonial anecdotes that we're getting
from some of the participants are quite encouraging. In fact,
the hospital doctor himself commented off-the-record recently
that he was quite interested in the vitamin C connection with
AIDS. So, I do believe it is well worthy of continued study and
may offer an immunochemical supporting regime towards immune
Regarding questions about stress, Bland commented:
I would say, "What does the word stress mean to you,"because
it's a very personalized definition. They could say, "It
means buzzing in my ears, or high blood pressure, or I can't
cope, or I get stomach upset, or I get diarrhea or feel confused."
These are interesting ways of using that patient's/client's own
identification system. Then say, "You've identified stress
as insomnia. Let's talk about the things that we know about sleep
disturbances. Are you getting regular exercise? Are you staying
away from excessive sugar in your diet? Are you getting adequate
B-complex nutrients--because the brain which represents only
6% of our body weight consumes about 20% of our energy, and it's
a very nutrient-dense part of our body. If you're not properly
nourished, the brain is probably the first part of the body that
is adversely affected. That's why you can get changes in behavior
and perception and sleep disturbances. Therefore, we want to
concern ourselves with the B-complex nutrients. And we want to
look at magnesium because that's another nutrient extremely important
for normalizing proper nervous system function." So using
their own symptoms of stress, you can work down into the holistic
approach towards stress management.
When asked what else retailers should become knowledgeable
about, Bland rattled off a long list of biochemical terms and
tidbits, including: therapeutic uses of serotonin, phenylalanine,
and catecholamines; use of tyrosine as a supposed brown fat activator
substance because of its supposed noradrenalin relationship;
and use of lysine and arginine in balance--lysine as an anti-viral
substance, arginine as an inotropic agent which tends to stimulate
the thymus gland output of thymosin which is an immune-activating
hormone. "These are all exciting areas that require some
technical competency on dose, how they work, their route of administration
and dose schedule--things you should have in the back of your
mind even though you're not going to prescribe for treatment."
Bland also mentioned chromium, selenium, manganese, copper
and zinc. "All of these have their own specific types of
physiological functions. What you have to have at your fingertips
or memory tips is some little vignette on each of those minerals,
their bioavailability, the foods that they come in, why they
are commonly the most deficient elements in the standard American
diet. Eighty percent of them are lost by processing whole grains
to white flour products. In the high-sugar, high-fat diets, where
two-thirds of the calories come as sweet fats, there are very
few trace elements. So there is a major area that the nutrition
products industry can say something very well substantiated about
the quality of the American diet."
He also listed fish oils, linseed oil, antioxidants, free
radical pathology, antioxidants, chain-breaking antioxidants,
lipid peroxides, rancidity factors, glutathione, coenzyme Q,
superoxide dismutase, betaine hydrochloride, intestinal ecology,
toxic bowel, and high-fiber foods.
Bland advised that adding "high-tech" in the form
of journals, topical literature files, slides and audio tapes
"would show people you are really looking at the science
of nutrition." But he warned: "It is very easy to give
up the high-touch type of format that makes this industry unique.
It's extremely important not to compromise personal attention
for technical expertise. A person really wants to have their
needs dealt with by a caring, humanistic salesperson who has
some level of competency, but I would say the competency is second
to the personal concerns. If we trade off technology for concern
then we've made a real bad mistake about the direction of this
"A few well-informed highly motivated consumers are your
best advertising and sales force. My mother, who is a tremendously
zealous advocate of nutritional products, has virtually made
one of our health food store's business. She goes to all of her
clubs and her social events. She is a missionary, saying 'You
ought to be down there talking to the local health food place.'
Because they have confidence in my mother, that kind of word-of-mouth
confidence-builder then comes back to you. It is like training
hundreds of salespeople to go out in the community."
When asked about the value of hair analysis, Bland replied:
Nutritional assessment is certainly justified on the basis
of nutrition education and information either by computer, diet
scan, or whatever diet technology you use. This is a valuable
part of your service that customers may not be getting anywhere
else, probably not from a doctor, for very few doctors are doing
nutritional scans or evaluations. Hair analysis and similar diagnostic
or prognostic screening tools have no place in a standard health
food store. If you are into education or community service, the
last thing you need is to be stigmatized as a quack or repository
of cultist information. So by staying away from hair analysis
and putting that into the hands of professionals who are licensed
to do so, you can do your job best: education transfer, information,
and nutritional counseling.
Another retailer asked about the limits of advice: "A
lot of people come into the store seeking alternative medical
answers. For example, two weeks ago, a friend of mine came in
and said he had gallstones. I told him my wife's father had had
gallstones, had refused surgery, and went through a specific
treatment that worked. It wasn't a wives' tale. It worked. Do
you have any comment on how far legally we should or shouldn't
go in sharing things like this with customers?"
If a client asks a question that specific, you need to decide
whether he is a client or a friend, and how well you know him.
If he is a friend, then I would take him out to lunch, away from
your store and talk to him as a friend. Don't talk as the store
proprietor because that would be diagnosis and treatment. No
matter what you think you are offering as a service, you are
really, by the letter of the law, doing things that could be
interpreted as diagnosis and treatment. However, if, as a friend,
you anecdotally talk about your experience as a human being,
there's no law that prevents freedom of speech.
What are the implications of this seminar? What does it tell
us about the attitudes of the health food industry? Do retailers
really benefit from exposure to a long list of preliminary research
findings? What do they do with this information? Are they qualified
to understand it, or do they merely absorb clichés for
use in selling supplement products? How much do retailers think
about their limitations? Do seminars of this sort encourage them
to go beyond their limitations? Is there really a difference
between giving advice ("prescribing") and steering
a customer to a piece of literature that gives the advice? Does
anyone in the health food industry ever suggest that retailers
faced with anecdotal evidence try to distinguish between cause-and-effect
And what of Bland? Has he considered that retailers might
lack sufficient background to utilize what he talks about? Does
he really think they should form opinions and advise customers
about types of breast lumps? What is his purpose in mentioning
preliminary studies (pertaining to products in their stores)
and then saying don't use them yet as a basis for recommending
products? Many of his ideas about nutrient needs run counter
to those of the scientific nutrition community. Does he deliberately
slant his presentations to promote sales of the health food industry's
Jeffrey Bland's Sales Aids (1986)
"Hesitant to answer questions your customers may have
about their nutritional concerns? For $79.95, add a doctor to
your sales staff." So begins a recent ad in Natural Foods
Merchandiser for four items produced by Jeffrey S. Bland, Ph.D.:
- Why Nutrient Supplementation? ($79.95), a 20-minute videotape
or 35mm slide/audiocassette program, is intended for in-store
customer viewing. In it Bland claims that: (a) "marginal
deficiencies" are common in the United States; (b) many
people who are under the presumption that they are healthy because
they are not diseased would actually benefit from higher levels
of health if they were taking a regular nutritional supplement;
(c) if you eat a balanced diet, the need for supplementation
may be reduced; and (d) "prudent nutritional supplementation"
can "optimize nutrient quality" to help augment health
and prevent disease. Bland also lists ten situations where supplements
are supposedly needed, but says nothing about how individuals
can determine whether they fit these supposed categories. (Presumably,
those listening to the tape will either "play it safe"
by buying a supplement or ask the retailer for advice on "optimization.")
- Introductory Nutrition ($120), a 12-hour audiocassette home-study
course, "reviews the contemporary information concerning
nutritional therapeutics including the use of vitamin and mineral
supplements . . . for the serious student of nutritional biochemistry."
- Immunity and Nutrition ($100), a 12-hour audiocassette course,
"presents the latest nutritional implications in such conditions
as AIDS, Epstein-Barr virus, hepatitis, herpes, food allergy
and hypersensitivity, arthritis and other autoimmune diseases,
inflammatory bowel disorder, and chronic candidiasis" and
examines the supposed role in "normalizing the immune system"
of vitamin C, zinc, iron, copper, manganese, vitamin E, gammalinoleic
acid, folic acid, vitamin B12, arginine, EPA, DHA, selenium,
- Complementary Medicine Magazine ($30/year), published bimonthly
by Dr. Bland, is "dedicated to providing you with the information
you need to stay at the leading edge of preventive medicine."
It is also said to be aimed at "wellness oriented physicians."
Each issue contains articles and ads promoting unproven practices
-- Stephen Barrett, M.D.
The above article and Dr. Barrett's note were published in
the May 1986 issue of Nutrition Forum newsletter. Mr. Fanning
was a freelance science writer who produced the nationally syndicated
consumer action column, "Help-Mate," and was Nutrition
Forum's Washington correspondent. He was also editor and publisher
of Con$umer New$weekly.
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This article was posted on December