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)

Example 2 read here (not presented)

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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