Who Can You Trust For Diet Advice?

by | May 1, 2009
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Last time I gave you a list of 10 people you can’t trust for diet advice, but many of you were left wondering who can you trust? As I alluded to before, it is extremely difficult to give a generic answer to this question because, frankly, there is no single group of people I can point to and say, “These people always do it right.” This is never true.

Where To Start

In the comments on Wednesday, reader Steve Parker M.D. (blogger and author of The Advanced Mediterranean Diet – visit his new Diabetic Mediterranean Diet Blog) said he mostly relies on primary scientific literature for his information. “Primary” literature is the original study where the actual scientific data is published and analyzed. This is very different from a newspaper article or press release (what a newspaper article is based on).

Without a doubt going straight to the source is the best way to get the facts regarding food, health and nutrition, and this is exactly what I do.

The Catch

It would be wonderful if we could all read the science directly and decide for ourselves how to eat for health and weight loss. But unfortunately, most people do not have access to these studies unless you are on a university campus or pay the exorbitant subscription fees (hundreds of dollars) for each individual scientific journal (there are thousands).

Moreover, unless you have extensive training in biological sciences (more than a bachelors degree), these papers will make no sense to you anyway. Some people try to get around this by reading only the abstracts, but reading an abstract to comprehend a scientific paper is like trying to understand a Seinfeld episode by reading the TV Guide (only more irresponsible).

This is the root of the problem.

Scientific experimentation and analysis is incredibly complex and requires decades of training. Therefore the general public needs the data translated into plain English and explained in simplified concepts. It is tempting to believe that anyone with the appropriate education and a knack for writing can provide this service, however the nuances of data interpretation make this very tricky business. It is frighteningly easy to spin ideas and make claims the data does not really support. This is even scarier when you think of health and how many lives are at stake.

The difficulties that arise from this issue are far reaching. At the most extreme, we have seen that research funded by industry is biased toward a favorable result for the company conducting the research.

Another potentially dangerous scenario is the misinterpretation of data by press rooms and journalists, who then translate these false ideas to a wide audience. Finally there are well-meaning people who do their best to alert the public to important health concerns, but simply misinterpret the science for one reason or another.

Who Is Qualified?

Scientists Although I myself may be biased, I am inclined to trust the opinions of well-respected (highly published) scientists in the field of food and nutrition. Luckily, several of these people have written wonderful books clearly explaining the basics of food and health. Although I am probably the only person under 50 to have ever read these books, they are wonderful resources that I recommend whole-heartedly.

Here are my favorites:

Eat, Drink and Be Healthy by Dr. Walter Willett

Mindless Eating by Brian Wansink

What To Eat by Marion Nestle

Smart journalists Despite my tirade above, scientists are not the only ones with good diet advice. Some journalists have the intelligence and tenacity to uncover all the necessary information and convey it to their readers. To know if you have found this kind of journalist you must read their work and make critical judgments about the logic and conclusions drawn from the data provided.

I have read more bad than good books by journalists, so please be skeptical of what you find. Note: extended book reviews are on the future agenda at Summer Tomato (for short summaries please read the captions under the books in the Summer Tomato Shop).

So far the most thorough analyses I have read from any journalist are the works of Michael Pollan. I also think the work of Gary Taubes is essential reading.

These are the best books on food and health ever written:

The Omnivore’s Dilemma by Michael Pollan

In Defense of Food by Michael Pollan

Good Calories, Bad Calories by Gary Taubes

Trained nutritionists and dietitians I have also been impressed by many of the nutritionists I have encountered (especially Dinneen at Eat Without Guilt – find her on Twitter @EatWithoutGuilt). Nutritionists and registered dietitians are specialized in nutrition, food and eating. These professionals are skilled at working closely with an individual to develop personal eating plans. Although they are not specifically trained to read and interpret scientific studies, their education ensures substantial familiarity with the literature on nutrition, putting them ahead of most medical doctors.

Conclusion

In general you should be more skeptical than accepting of diet advice–particularly if the recommendations sound very strange or unnatural to you. However there are many good resources if you are careful to choose them wisely.

I am always looking for more book recommendations. See what I have read in the Shop and leave your additions in the comments.

Thanks to everyone who has participated in this lively conversation!

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21 Responses to “Who Can You Trust For Diet Advice?”

  1. Karin says:

    Great post, thanks Darya! I went to that link about the study of industry bias, and you’re right it was kind of jibberish to me. You have great points about non-biased parties interpreting those studies. How do you judge if it is a good study though?

    • Darya Pino says:

      I’m afraid that’s the hard part, Karin. A few things I consider are the validity of the experimental design, the quality of the controls, the rigor of the statistical analysis and how carefully conclusions are made.

      This is why training and education are so important.

  2. Linda Simon says:

    Nutritionist or dietitian
    In WI, and in some other states I believe, anyone can call themselves a nutritionist. Legally, there are no education requirements here despite what the Bureau of Labor Statistics has on their website. So people without any advanced training can call themselves nutritionists. Or people with degrees from diploma mills. Buyer beware.

    We also have registered dietitians who call themselves nutritionists. In part because the public seems to prefer this term to the dietitian term.

    To legally call yourself a dietitian, one must have graduated from an approved bachelors program, completed 900 internship hours, pass the registration exam, and maintain continuing education.

  3. Berni says:

    Another book I’ve found to be essential for me is The Don’t Go Hungry Diet by Dr Amanda Sainsbury-Salis PhD. A great example of someone making headway with clinical trials AND translating all that data for the general population.

  4. Thanks for mentioning my book and blogs, Darya.

    Here’s yet another problem with the scientific literature that you know about but most people don’t: publication bias. Science journals prefer to publish “positive” studies, so there’s bias against negative studies.

    Example: Suppose researchers discover that bowling regularly is associated with a tripling of the risk of colon cancer. That’s news! It’s surprising. That’s a positive study. If the research appeared to be well-designed and conducted by reputable scientists, it would tend to get published. On the other hand, eight other studies find NO association between bowling and colon cancer. They are negative studies. That’s not surprising, and it’s boring. They are not nearly as likely to get published. So you’d never hear about them.

    Let’s assume there is no association between bowling and colon cancer (probably there isn’t). I’m sure if you ran enough epidemioligic studies – say, 100 – you would find one or two that suggested and association, but this would be purely by chance. Those one or two “positive” studies are much more likely to see the light of day in a publication.

    -Steve

  5. Meg Wolff says:

    You may want to add The China Study by Dr. T. Colin Campbell, to your list.

  6. Linda Moran says:

    This was a great set of articles. I use my nurse practitioner for advice, as she seems to be really up on nutrition, as well as supplements. She seems to know way more than my primary care doctor. Also, what are your thoughts on Dr. Andrew Weill? He’s local to Tucson, runs alternative medicine program here, and I’ve read a good many of his books. He seems to fit your criteria – what do you think?

    • Darya Pino says:

      Thanks for asking aboug Dr. Weill, Linda. I have heard a lot about him, some good some bad. I have been meaning to read his biggest book, but still haven’t gotten around to it. I will certainly keep you posted when I do!

  7. Couldn’t agree with you more, Darya! I try to understand the studies, I’ve read all those books, am under 50, and am always hungry for more. But I was a lawyer for years, so I can read complicated stuff, and I’m also personally interested in those things. I think for the average person, however, it’s complete information overload/jibberish, and that coupled with the fact that their caregivers are usually clueless, leaves them acting on hearsay from friends, family & colleagues and relying on front-of-package claims from food manufacturers.

  8. Janine says:

    Great post, as usual. However, I don’t agree with your comment that you need more than a bachelor’s degree to understand scientific studies. Although this may be true with a lot of BSc degrees, dietetics graduates (as Linda Simon eluded to) are highly trained to read and interpret these studies within our 5 years of training, because it is so imperative to our work.

    I can’t speak for all University dietetics programs, but I know this is how it is for most in Canada.

    Keep up the great work!! 🙂

  9. R Noel Rodriguez says:

    I recently joined your site and find it mostly interesting. This topic, “who to trust” on dietary issues is especially important. That Michael Polland recommends that you don’t eat anything that your grandmother wouldn’t recognize as food should be a mitigating point about not trusting your own mother’s advice. After all, your mother supposedly learned everything she knew about food from your grandmother. The best advice I have is to be your own advocate and take responsibility for your diet. Read everything you can concerning your food and nutrition, moderate your intake, and enjoy life.

  10. Jo says:

    I agree with you that MD’s shouldn’t be giving nutrition advice to the nation as a whole or writing diet books. I also agree in treating USDA guidelines with skepticism. But I don’t know that individual scientists should be the gold standard either. I think the idea of a “panel of scientists” is better. There is always some objectivity in data interpretation and I think the any diet advice given to the public should be a productive of a collective of the best minds. The term “peer-reviewed” should be expanded here. And intelligent journalists (like Pollan) should certainly be included, of course.

  11. Emily says:

    You make a very valid point, and I’m glad to hear someone saying that we cannot trust our government or any government agencies for diet advice. However, I’m not entirely sure all scientists are the best qualified, either. I base this on the fact that, as Michael Pollan agrees, what we eat shouldn’t have to be complicated.
    You are taking the very rare perspective of combining scientific evidence with accessible action steps. Your advice to eat your vegetables, skip processed food, learn to cook, etc., is very sound, straightforward, and simple.
    My interest lies in the fact that if you told ten people this is what they should do to lose weight, prevent disease, and live longer, maybe one of them would actually do it. Figuring out what prevents people from following such simple, overarching principles is the key to getting people off processed foods and back in the kitchen.

  12. Jessica says:

    I know others have already mentioned Registered Dietitians in these responses but I just wanted to put in my two cents as an RD myself. The minimum requirement is a BS but over half of RDs have a master’s degree and all are required to keep up on continuing education to keep their credentials. While there are some dietitians hired by government agencies such as the Dairy Council and USDA, many are huge advocates for the local food movement and are excellent sources for the public when it comes to sifting through all the convoluted nutrition information out there. Dietitians are well versed in disease specific diets and unlike MDs are focused on the preventative powers of nutrition and a healthy lifestyle. There are dietitians in hospitals, outpatient clinics, school districts, community health organizations, WIC clinics (we’re also big advocates of breastfeeding), private practice, working for grocery and health food stores, research, corporate health programs, etc. I would recommend you familiarize yourself with the efforts of dietitians in the community and in healthcare as well as their role in nutrition research as you continue to write this blog. I think you’ll find that your interests align well with our profession and maybe you will consider recommending a qualified registered dietitian as a good source for your readers.

  13. Shae says:

    What impacted me the most are scientific journals that need to be broken down into lay words in order for the general public to understand if they don’t attend college. Being a college student, scientific journals can be difficult to read, but provides a wealth of information. Great article, thank you!

  14. Joey Gochnour, RDN says:

    Good article. I will say as a registered dietitian nutritionist (RDN–we can use RD or RDN) that we have extensive training, even for just the RD credential, in reading scientific studies these days. It is required during our internship experience (which is 1200 hours now, not sure if someone else listed 900 hours), undergrad, and for those of us who have been in school for 9 years, grad school sufficiently covers more research. The Academy of Nutrition and Dietetics is working hard to market to the public, since we live in a capitalistic society and a consumer has a right to choose whether they want someone with a nutrition education or no nutrition education giving them advice, that we are a nutrition expert and highly qualified toward preventative care. Unfortunately, the way the insurance companies work, it helps us a lot to partner up with a doctor because they don’t pay for much directly through a dietitian.

    But yes, just because someone is a dietitian does not mean they are up on the science for your particular question. We specialize just like other professions. Don’t ask a hospital (clinical) dietitian who works in acute care pediatrics/geriatrics about sports nutrition, or a food service dietitian about diabetes counseling. Read up on someone’s bio before you take nutrition advice from him or her. There are WAY too much of the personal trainer/business types of people (and I say that as I also am an exercise physiologist) stepping outside of their scope of practice. Unfortunately, dietetics and exercise science programs are very weak in business practice–so you don’t see many true professionals in these field on the internet like you see people who know how to sell. The problem with diet and exercise is everybody considers themselves an expert. People will take advice on this subject from anyone because they don’t take it seriously. I wouldn’t go to anyone but a lawyer for legal advice or anyone but a CPA for my taxes. I wouldn’t go to talk to someone with a PhD in neuroscience about nutrition.

    A personal trainer certification means they passed 1 test and paid a fee to whoever wanted to put out the certification. It is red tape to work at a gym. I also have a BS and Master’s in kinesiology and exercise physiology and I still had to take a personal training exam to work as one at a gym. I think it is backwards that they require a certification instead of a degree.

    Joey Gochnour, BS, BS, M.Ed., RDN, NASM-CPT

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