I am the expert and you must listen to me! Have I lost you? I don’t blame you. Communicating complex science is always going to be tricky. But most people wouldn’t claim to understand or have experience of astrophysics whereas everyone eats, so everyone can claim to have knowledge about nutrition. A quick glance at the #nutrition hashtag on Instagram reveals that the majority of the content comes from brands, influencers and celebrities and not from registered professionals with a background in nutrition. Obviously, this means that pseudoscience and miracle cures drown out the facts, which is to the detriment of public health but what can and should people like me do about it?
“A lie can travel halfway around the world while the truth is still putting on its shoes”
This quote, attributed variously to Mark Twain and Jonathan Swift, highlights the struggle we face. Let’s see this in action with a very recent and achingly depressing example that, quite frankly, makes me want to give up and become a plumber.
An Israeli startup, Accelerated Evolution Biotechnologies (AEBi), announced in January, covered by the Jerusalem Post, that they had discovered the first complete cure for cancer. Not only was the article misleading to the public on the characteristics of cancer and drug development, the research was based only on petri dish and mouse studies and fell far short of the standards required to make such claims. However, as we’ll see, a “Cure for Cancer” piece is always going to be more sensational, popular and shareable than an article saying “Cancer is still awful”.
As you’d expect, the Jerusalem Post article was widely shared across all major news networks and then across social media. But, in a disaster of poor journalism, the majority of articles that were seeded by the original were mere copies of the information with no fact checking (see the red dots in the picture below, taken from here). A few articles asked for expert input but gave the reader no clue as to the conclusion they should draw (so called “he said, she said” articles, shown in yellow). Only a very small minority of articles referencing the original post were properly fact checked and showed that the claims were highly misleading (the green dots).
What’s even more depressing is that the majority of the social media shares were of the articles that were not fact checked. The repeat or ‘he said, she said’ articles were shared 3.8 million times compared with a mere 0.12 million shares of the fact checked articles. That’s 97% to 3% of total shares. Some news agencies did issue subsequent articles with expert comment, debunking the original misleading science but it came too late. Each of these was shared only a few thousand times, compared with hundreds of thousands of shares each of the sensational articles.
None of this myth perpetuation is helped by social media algorithms, which amplify posts that are popular, regardless of whether they are true, evidence based or ethical. This was a perfect storm of bad science, poor journalism and a natural human desire to seek for hope in tragic circumstances.
And this is not an isolated incident. While this example highlights in gargantuan terms the way a myth can be perpetuated, this is happening on a smaller scale on a daily basis, not just in the press and on TV but across social media and marketing. We face an onslaught of nutribabble, some of it well-meaning and relatively harmless and some of it deliberately engineered to instil fear to promote a product, personality or cause.
The power of storytelling
If you’ve not visited Gwyneth Paltrow’s lifestyle site then please don’t. In short, it’s a glossy website full of wellness blogs that bristle with pseudoscience and a range of products like the infamous jade egg aimed at enhancing sexual pleasure if you just insert into a certain (ahem) area, as well as all the detox, juice diet, charcoal smoothie nonsense us nutritionists love to hate. It’s a festival of woo.
But it boasts 2.4 million unique visitors a month. Such is its success that Goop is now merging with Netflix to create a TV series that aligns with the Paltrow ethos. Something tells me this is not going to be incisive, evidence-based health journalism but it’s likely to tell an engaging story and promise miracle cures that have barely a shred of truth in them.
Now many a scientist has expended time and effort meticulously debunking each and every narrative on Goop, whether a blog or a product promising health, beauty, longevity and sexual pleasure. However, as Dustin Moore points out in his excellent blog, who doesn’t want these things? Particularly when they’re being sold to you packaged with a beautifully crafted narrative? Goop is not in the business of health. It is in the business of storytelling, of selling a dream, regardless of whether that dream is a reality or not (and let me tell you, it most certainly is not). You cannot fight these claims with science because they are not grounded in science to begin with and they appeal to emotional not rational motivations.
Paltrow is an actor. Her craft is storytelling, not science. And we can laugh at her, deride her and dismiss her but she has the public’s attention far more than the experts do.
But FACTS! We have facts!
I’m going to level with you here. Registered Nutritionists and Dietitians the world over have facts coming out of their ears (and I’m sure there’s an ointment for that). If only we could shout them a bit louder; if only the public and the media would recognise our qualifications, our credibility, just how important we and our facts are, then the public would change their behaviour and listen to us and not Paltrow, Dr Oz, Gillian McKeith and a raft of young beautiful influencers selling turmeric shots on Instagram.
Except this is the real world. Facts don’t cut the mustard in the way scientists expect. Moreover, mere facts alone do not evoke behaviour change if an individual does not have the capability, opportunity and motivation to change – you have to want to make a change to your lifestyle and you have to be able to make that change. Look at the 5 a day message, one of the most widely recognised UK public health campaigns. We all know we should eat more fruit and vegetables and yet, dietary survey after dietary survey shows barely any change to our average intake as a population – on average we eat 4.2 portions a day. The truth is, brownies taste better than broccoli and if you’ve a fiver to spend on food for the family for the weekend, you want the most calories for your money and they won’t come from kale.
Facts are not enough. Now this is not a blog about public health and behaviour change. I’d need to write a book on that and indeed many experts have. My point is, while facts are important, how they are delivered is just as important. In the words of Ed Yong, a science writer: “You cannot displace a feeling with a fact”. You might be able to influence an individual but if you are challenging a strongly held belief, you are going to have your work cut out with facts alone.
We’ve had enough of experts.
Ah Michael Gove. This much derided statement was unfortunate but, and it saddens me to say this, it reflects a public view. Particularly when it comes to nutrition science: a young science that lacks the history of chemistry or physics. We do not even have all the facts. There is so much we do not know. Hence, when asked black or white questions by journalists or the public, as the experts, we cannot answer in binary terms.
Is saturated fat bad? Well, it depends. It depends on the type of saturated fat; how much you eat; if you eat less, what you replace that saturated fat with; your genetics; whether you have underlying medical conditions and so on. It’s complicated. But if I sit on the BBC Breakfast sofa and say that alongside a seemingly erudite, confident, (usually self-appointed expert) individual who says, “Saturated fat is a health food. I put butter in my coffee and eat coconut oil three times a day. The Government have been lying to you, trying to make you eat sugar and refined carbohydrates to make you ill because they are being paid by the sugar industry,” who are you going to believe?
And this is the problem. People naturally want simple answers to complicated questions and nutrition science can’t deliver but a multitude of snake oil sellers can. They’re often highly articulate, media trained, attractive individuals, often with books and products to sell and we want to believe their story or we want to buy into their glossy lifestyle. Science cannot deliver the same sort of certainty or dream.
Do I give up and start a plumbing course?
No! But I have a stark message for my profession. We have to work harder. Shouting louder to get our voices heard and our qualifications recognised only gets us so far. We have been complacent, maybe naïve and perhaps even a little arrogant in thinking that all we need is to turn the volume up. We need a sea change in how we communicate. I don’t have all the answers nor do I have a degree in science communication or a raft of thousands of social media followers but this is my twopenneth for my profession:
A message for the public on spotting nutrition woo
If you’re reading, watching or in any way consuming nutrition information, here are 5 simple ways to sort the woo from the true:
A final plea to journalists
There are some brilliant investigative journalists out there who use trusted professionals and who write balanced articles but while there are other journalists who court sensation, spread misinformation and cherry pick statistics to generate the best headline, pseudoscience will always win over the truth. Journalists need to rely on information from Registered Nutritionists and Dietitians rather than self-appointed experts but equally, they have to understand that someone bound by a code of practice cannot endorse miracle cures or promise certainty. As the saying goes in journalism: “If someone says it’s raining, and another person says it’s dry, it’s not your job to quote them both. Your job is to look out the window and find out which is true.”