Diet discussions in the social media – A dietician’s view
Presented at 8th World Congress of Science Journalists
2013, Helsinki, Finland
[Updated December 2014] Registered dietician, M.Sc, MBA
Reijo Laatikainenwww.pronutritionist.net
www.pronutritionistblog.com www.twitter.com/pronutritionist
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• Posted more than 500 posts at different 4 blogs
• Engaging in discussions in Finland, US, UK and Australia
• Follow nutrition literature• Meet patients regularly
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My view is based on participation
Why do discussions on diet heat up?
These are my personal views
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Academics
Media
Individualism
Dieticians and nutritionists
Interest groups (low carb, vegans
etc.)
Dieticians are often absent or cautious. Stand up for the discipline, as a profession!
Selling news & hunting clicks is rife in some media.
Too often black & white, sluggish to admit mistakes & overselling own studies
Cherry picking, ridiculing & dismissing opposing data as a chosen strategy
“I’m the best expert on my health”
✔
✔
I’ll only focus on two of these. Nutrition authorities and media,
because …
It’s certainly true that some prominent low carb, vegan, paleo & other diet proponents cherry-pick data, dismiss opposing studies
and ridicule ”opponents”. However, this is so obvious that I don’t find it particularly
interesting.
1.
Public health messages cast by nutrition authorities are
exaggerated or simplistic
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Shades of grey. It is risky to oversimplify science for the sake of a clear public-health message. Nature 2013:497; 410 (editorial)
• Professor of Pediatrics in the Division of Endocrinology at University of California, San Francisco
• Eagerly praised and followed by low carb and paleo communities
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How a single ecologic (correlation) study becomes the ultimate piece of evidence
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Sugar usage was linked to incidence of type 2 diabetes in an ecologic study
Correlation of sugar availability and type 2 diabetes worldwide
Basu S, Yoffe P, Hills N, Lustig RH. The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data. PLoS ONE 2013; 8(2): e57873
Press release
2.
Media spices up the story and oversells the outcomes
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Mark Bittman, NY Times stretches Lustig’s findings further…
• ”The take-away: it isn’t simply overeating that can make you sick; it’s overeating sugar. We finally have the proof we need for a verdict: sugar is toxic.”
• ”Obesity doesn’t cause diabetes, sugar does”.
New York Times (It’s sugar, Folks 02/28/2013)
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8 days later, a correction appears
But who reads the correction anyway?
Damage is done and one dogmatic view is facilitated.
Simplistic and exaggerated
Example 2, read here (was not presented)
This is how it often goes when conclusions become distorted in
media and in a population.
4 Opinion, comment,
blog
3 News2 Press release
1 Scientific paper (article)
Media and academics do each have their role and cannot accuse only the bad behaving in social media
Authors presentresults
University sells the
storyto media
Media sells the story to people
Someone further
exaggerates and modifies data/context
Furthermore, there truly is contradictory data in the field of
nutrition.
It’s rarely black and white.
Example 1
Cancer and diet in cohort studies
Schoenfeld & Ionnidis. Is everything we eat associated with cancer ? A systematic cookbook review, Am J Clin Nutr December 2012 ajcn.047142.
Sometimes variety of results is very broad (cohorts)
Hierarchy of evidence is usually not well articulated or appreciated →
Surrogate/cohort/mice studies tend to get equal attention as randomized
hard end point studies and meta-analyses.
Media embraces contrary results.→
a mess 22
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One step forward?
Lets’ use the ranking tool for evidence. It’s been around for
long.
1. Randomized mortality & morbidity trials
2. Prospective cohorts
3. Randomized risk marker studies
4. Cross-sectional and case-control cohorts
5 Ecological & animal studies
Stre
ngth
of e
vide
nce
Meta-analyses of 1,2 & 3
Modified from: Micha & Mozaffarian. Lipids. 2010; 45(10): 893–905 and
Evidence Analysis Manual.Academy of Nutrition and Dietetics
January 2012
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Let’s face it (despite our best effort):
There will always be media which do not seem to care about the ”truth” but rather focuses on
exploiting debates
Low Carb Diet
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Good Diet Bad Diet
My two hopes for both media and nutrition authorities.
Less black and white statements and less focus on selling.
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One more hope.
Let’s stop accusing short-sightedly the “bad” people across
the border (low carb/paleo advocates, vegans, super foodies, dieticians, authorities, university
press officers etc. )
Let’s clean up our own behaviour and language too.
www.pronutritionist.netPage 29
“Everything should be made as simple as possible, but not simpler”
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Recommended readings
• Hughes V. The big fat truth. Nature 2013:497;428–430
• Shades of grey. It is risky to oversimplify science for the sake of a clear public-health message. Nature 2013:497; 410
• Sumner Petroc, Vivian-Griffiths Solveiga, Boivin Jacky, Williams Andy, Venetis Christos A, Davies Aimée et al. The association between exaggeration in health related science news and academic press releases: retrospective observational study BMJ 2014; 349:g7015
• Goldacre Ben. Preventing bad reporting on health research BMJ 2014; 349:g7465
Wellcome aboard!
http://twitter.com/pronutritionisthttp://www.facebook.com/pronutritionist
http://www.pronutritionist.net
Reijo Laatikainen, registered dietician, MSc, MBA
Images bought and licensed from BigStockPhoto. Snapshots from papers and sites refered to.
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