Confusion

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A friend and I recently got into an email exchange about how rapidly nutrition advice seems to shift and how this often leaves people confused, frustrated, and feeling paralyzed about what to do.

No doubt, guidelines do evolve in response to new research, and in fact the Dietary Guidelines for Americans are updated every five years.  The shifts, while perceived as quite fickle, are much more subtle than most people realize.  However, the reason we perceive nutrition advice to be oscillating like the ever-changing wind is not due to this evolution, but rather because of misinformation.

Take yesterday as an example.  Each day, Joanne and I receive a blast of nutrition-related articles.  For each topic, we are provided with the story geared towards the general public, such as an article in the New York Times or Boston Globe, as well as the research piece or journal article on which the story is based, such as a piece in the New England Journal of Medicine.

Yesterday’s topic read, “Fats and Oils That Can Improve Your Health.”  As soon as I began to read the story, something seemed fishy.  Ghee and coconut oil topped the list of supposedly-healthy fats.  Although alternative medicine touts both of these fats as having health benefits, the research up to this point has not supported these claims.  Therefore, I was surprised to see them headlining the list.  When I got to the bottom of the article, I discovered that sure enough the story was written by a “Holistic Health Counselor,” as opposed to a credentialed and licensed expert in the field.

Next, I read the position statement released by the Academy of Nutrition and Dietetics on which the above story was supposedly based.  The content of the two publications bore little resemblance to each other.  Regarding coconut oil, the Holistic Health Counselor wrote, “This versatile oil goes well with both sweet and savory dishes and boasts many health benefits.  Made up of medium-chain fatty acids, this oil is good for those trying to lose weight because the body can easily use this healthy fat for energy.  A large portion of the fatty acids found in coconut oil are made of lauric acid, which can serve as an antimicrobial, antiviral, and antibacterial, helping to combat viruses and boost the immune system.”  On the other hand, the position statement read, “New food products containing coconut oil and other palm oils (eg, milk, spreads, yogurt) are touting health benefits of MCTs [medium-chain triglycerides, or medium-chain fatty acids].  Given that 44% of coconut oil is 12:0 and 16% is 14:0, and these fatty acids are hypercholesterolemic, consumption of coconut products is not currently recommended.”  Do you see any relationship between these two passages at all?

Omitting a link to the Holistic Health Counselor’s story was a conscious decision on my part in order to avoid further dissemination of misleading information.   If I showed you the article though, you would discover that it is concise, organized into a list with bold headings, and features colorful and attractive photos as well as a head shot of the author.  Compare that to the text-heavy, chemistry-laden, pictureless, 18-page monstrosity that is the position statement.  The former will attract more readers and gain steam and wide circulation due to forwarding to friends, postings on Facebook, etc.  The latter is lost in the dust, only to be read by the likes of me.

Generally speaking, most people never read primary source articles.  They simply trust that the stories they read summarizing said articles do so with a high degree of accuracy.  Unfortunately, just like in the game of telephone, details and facts get lost or skewed with each iteration; the ultimate and initial messages conveyed often do not match.  The mismatch is what makes playing telephone fun and interesting, but in real life the consequences are negative.  A patient comes into my office having read the more popular article and understandably believes the content to be true, but then he or she hears me present the position statement’s stance.  “Have the guidelines already changed?” the patient asks.  “Who should I believe?  What am I supposed to do now?”  No wonder people feel stuck and confused.  Part of our work then becomes to undo this confusion so that the patient can move forward.

In a culture where we have limited time and attention spans, we get a great deal of our news through tweets, scrolling headlines at the bottom of the television, and sound bites.  Media members, fully aware of the small window they have to present an idea and under pressure to break a story first, sometimes sacrifice checking facts and preserving key messages.  The pressure to be first and to accumulate clicks, retweets, and Facebook likes is king while the responsibility to be accurate gets lost in the shuffle.

Somewhere along the line, somebody suggested to me that I should shorten my blogs.  People have neither the time nor attention span for my entries, and who besides my mom reads all the way through to the end?  Shortening my blogs, I am told, could increase our Facebook fans and Twitter followers, thereby making Soolman Nutrition and Wellness LLC more popular.  That could be true, but my position as a source of reliable information is one that I take seriously, and I am not about to sacrifice my credibility for some extra likes and retweets.  Despite today’s be-first-and-keep-it-short media culture, accuracy and completeness are still necessary in order to minimize confusion.

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