Pamela A. Popper, Ph.D., N.D.
Wellness Forum Health
It’s an election year, and we have three more months of political ridiculousness to go. I’m counting the days since I’m already tired of the lies, screaming (don’t these people know they can be heard without shouting into the microphone??), and the attack ads. At least there is an end in sight; it will be over soon.
But just as aggravating as political ads is the endless nonsense about nutrition that appears on television, in magazine articles, newspapers, and on websites. Watching it and reading it is like listening to nails gliding down a chalkboard. And this will not be over soon; we can look forward to a daily dose (or two, or three) of “nutritional nonsense” for as long as we choose to receive media messages. With this in mind, I’ve made a list of six ways in which media coverage leads to incorrect conclusions about nutrition and health.
Issue #1 Quoting Experts. Journalists think they should present a “fair and balanced” view of an issue, so when interviewing an expert about diet and health, they will usually interview someone who disagrees with the primary interviewee’s ideas. Theoretically there is nothing wrong with presenting both sides of an issue, but the problem is that in many instances the individual offering the counterpoint is not an “equal” to the principal expert.
For example, Dr. T. Colin Campbell is a nutritional biochemist and professor emeritus at Cornell University who conducted studies looking at the effect of nutrition on health for several decades. He has served on expert committees, co-authored policy statements, and has published over 350 articles, most of them peer-reviewed, in medical journals. If reporting were truly fair and balanced, the contrary view to Campbell’s statements would be someone with equal (or almost equal) credentials, research experience, and article authorship. Instead, lay people, other journalists, medical doctors who do not conduct research to document their claims about blood types and metabolic types, and best-selling authors of poorly written books (“best-selling” does not always mean well-written or well-documented) are often called on for their “expert” comments. The inclusion of these individuals in the discussion elevates them in the public eye and makes them appear more qualified than they really are, which then adds to the confusion. It is easy for members of the public to conclude that “experts” disagree, that no one really knows which diet is best for humans, and that there are no clear answers for commonly asked questions about diet and health.
Issue #2 Reductionism. Specific nutrients and foods are reported to have almost magical powers. I’m referring to headlines like “Blueberries fight cancer,” “Coffee Reduces Risk of Parkinson’s Disease,” and “Cinnamon Controls Blood Sugar.” Articles like these lead people to focus on making minor changes, adding a food or supplement, with the thought that these small changes will actually prevent or treat disease. Individuals who do not practice health-promoting habits cannot eat enough blueberries, drink enough coffee, or take enough cinnamon to improve their health. The bottom line is that there are no magical foods or nutrients but there are health-promoting diets and lifestyles, and these should be the focus of articles when discussing the prevention or treatment of disease.
Issue #3 Exaggeration. It’s unfortunate, but most of the people reporting on nutrition and other health-related topics do not know much about science, statistics, study design, and other important issues that should be considered in determining the validity of information. For example, in 2013 newspapers and other media outlets dutifully reported the findings of a study conducted in Spain, stating that this study showed that eating nuts or olive oil reduced the risk of cardiovascular events by almost one third. Americans were told the results were so spectacular that the study had to end early because it was unethical to keep the control group on the low-fat diet any longer.
At the time these reports were published, an article documenting the details of the study was published in the New England Journal of Medicine and was available online, which means that the reporters could have checked out the facts for themselves. But they did not. I did, and here’s what really happened.
The study was funded by an olive oil company and a nut company, both of which provided their products to the participants. The control group was not eating a low-fat diet; fat intake in this group averaged 37% of calories. The reduction in risk for the subjects eating oil was 1%, and for the nut eaters it was 0.6%.
The reason for the discrepancy in the actual numbers and the way they were reported was the use of relative rather than absolute data. Relative data always sounds better so it is used to exaggerate the benefits of drugs, supplements, and foods. In case you are not familiar with this strategy, I’ll provide an example. Let’s say that 1% of study participants taking a supplement have heart attacks and 2% of study participants taking a placebo have heart attacks. The reduction in risk for supplement takers is reported as being 50% (1% is half of 2%) but the actual risk reduction is 1% (the difference between 2% and 1%). You can see why promoters of drugs, supplements and foods like to use the relative numbers.
I can’t imagine anyone caring about a 0.6-1% reduction in the risk of anything. This was a poorly designed study with negligible results that received far more attention than it deserved because journalists often dutifully report what they are told, and often do not know how to verify health information on their own.
Issue #4 Fear Mongering. People should be concerned about chemicals, contamination and related issues. But an entire industry has developed around convincing people that the cause of our epidemic of disease and obesity is chemical exposure. Take BPA for example. It’s an additive in plastic bottles and the lining of cans. Small amounts of it are leached into water and food, and according to Daniel Doerge of the FDA’s National Center for Toxicological Research, almost all Americans have traces of BPA in their urine.
But a study conducted by the National Institutes of Health involved exposing rats to doses of BPA between 70 times and millions of times higher than the average American is exposed to in food and related products. Only when the doses reached millions of times higher was there any adverse effect.
Does this mean we shouldn’t care about chemicals? Of course not. But it is frustrating to watch people avoid drinking water from plastic bottles while they are clearly dehydrated, and avoid eating beans because they don’t have time to soak and cook dried beans and they are afraid of cans. The scary articles about chemicals distract people from paying attention to the things that really matter – like drinking the water and eating the beans.
Issue #5 Confusing Correlation with a Cause-and-Effect Relationship. This is often how new but unproven ideas about diet and health become widely adopted. It starts with an observation, which may be made by several people, that shows a connection between two things. For example, people who take vitamin pills have better health. The observation may be correct, but the question is whether or not the better health is due to taking vitamins, or is there something else going on? Well, studies show that people who take vitamins also practice a lot of other healthy habits, so their health status cannot be attributed to vitamin pills, but of course that is not the way the story is told. The media, provided with information by supplement makers and their associations, is told that people who take a certain supplement are less likely to develop cancer (an observation). This is then reported to the public. The supplement becomes popular and people think they are protecting their health by taking it.
Issue #6 Sins of Omission. In a perfect world, when it becomes known that a correlation is disproved in well-structured studies, the media would report that previous information was wrong, perhaps with even bigger fanfare. A headline like “Popular Supplement Does NOT Prevent Cancer After All” would be nice. But this almost never happens.
An example is what has happened with vitamin D. Simple observations showed that people who had various conditions ranging from obesity to cancer had lower vitamin D levels. Before research could be conducted to determine if lower vitamin D levels caused these conditions, a multi-billion dollar industry developed around testing vitamin D levels and selling supplements to remedy “deficiency.” This was helped by the media, which promoted the idea that almost everyone was deficient, and that supplements were needed in order to prevent disease.
The problem is that we now have significant evidence showing that low vitamin D levels do not cause disease. In fact a meta-analysis of 263 studies concluded that lower vitamin D levels are caused by disease. But there have been no headlines reporting this, and in fact the myth has been so persistent that the FDA intends to require food makers to list vitamin D on the “Nutrition Facts” part of the label.
What should the average consumer do? Take anything you read or see in the mainstream media with a grain of salt. Develop a healthy skepticism when looking at information from any source about health. And take some time to learn about how to look up and evaluate studies on your own so you are not so easily convinced by the popular press. (Wellness Forum Health offers some excellent classes – contact me at firstname.lastname@example.org if you want to learn more.)
 Gina Kolata “Mediterranean Diet Shown to Ward Off Heart Attack and Stroke.” New York Times Feb 26 2013
 Estruch R, Ros E, Salas-Dalvado J et al. “Primary Prevention of Cardiovascular Disease with a Mediterranean Diet.“ NEJM February 25, 2013 DOI:10.1056/NEJMoa1200303 http://www.nejm.org/doi/full/10.1056/NEJMoa1200303?query=OF accessed 2.28.2013
 John Hamilton “Maybe That BPA In Your Canned Food Isn’t So Bad After All.” http://www.npr.org/sections/thesalt/2014/02/26/283030949/government-studies-suggest-bpa-exposure-from-food-isn-t-risky
 Dickinson A, MacKay D. “Health habits and other characteristics of dietary supplement users: a review.” Nutr J 6 Feb 2014;13:14