Here’s something to think about…
Have we allowed ourselves to rely too heavily on Nutritional Science? A science that is fundamentally flawed at many levels.
Are we too easily convinced by those who fling around PubMed links and media’s sensationalised interpretation of research papers, just because it sounds sciency? Do those people even understand the study they are sharing? Or are they just trying to win an argument to support their bias?
What makes Nutritional Science Problematic?
Nutritional science (not mistaken with biology) is not like physics… where we can test theories with high degrees of consistency, rigour and lack of bias. Gravity is a universal and constant law. No exceptions. No personal unique lifestyles to consider. It always… just is.
Nutritional Science does not benefit from the same level of universal laws. Yes, we have biology textbooks and lots of experiments, but this science is still so new, and the subject of the human body is the most complex thing to understand. It’s a universe inside a universe, with millions of moving parts.
The methods we rely on within Nutritional Science is observational studies, epidemiology, clinical trials, animal models, in vitro studies and meta analysis.
Observational & Epidemiology
Observational Studies and Epidemiology is not about testing the mechanism. These studies are really about questionnaires and data science.
Ask a bunch of people what they eat, and then observe their health outcomes through time. At best, they can help draw correlations between self-reported food questionnaires and people’s health. They can provide clues that may form a hypothesis of nutrition’s effect on our health, but they do not prove causation. For that, we need clinal trials.
You may be surprised to learn that most of the regularly cited studies and papers are of this type. Such as the Blue Zones (Seven Countries Study), The China Study (a favourite of Vegans) and countless others. There is no proof of causation regarding the observations and conclusions of these studies, but many people will believe there is. Because… well, it’s a ‘study’. It’s science….
Clinical Trial come in various flavours, but the gold standard is considered Randomised Controlled Trials (RCT’s) that are designed to control bias, confounding factors and placebo/nocebo effects.
Problem is, they are expensive and very hard to design well. Ultimately, we’re talking about taking real human beings with normal lives and subjecting them to a tightly prescribed nutritional protocol – down to the gram, calorie and macros. Do you trust volunteers to to be 100% compliant? That’s optimistic at best.
So, the highest quality RCT’s are those which are conducted in metabolic labs and wards. Imagine the scenario – you are asked to live in a ward for several weeks. You are fed exactly controlled portions of various foods. You have zero free will. You can’t leave the ward, as the studies control will be lost. Fancy it?
For this reason, RCT’s are very expensive, hard to design, and can only run for a few weeks at best. Anything more is considered inhumane. But, the impact of food can take years or decades of exposure to create the observable symptoms. How much can we actually infer in 2-3 weeks?
And trying to control for calories, macros, lifestyle factors and other nutrients/foods such that all is consistent other than one variable is a seemingly impossible task.
Oh, and did I mention the money? Seriously, we’re talking about a lot of money. Money that doesn’t just appear out of thin air. Researchers are not funding their work. They need to pitch for funding and support. Which means the organisation or institution willing to offer the grant has an interest in the answer. I’ll touch on this again shortly.
Animal & In Vitro Studies
The use of mice, rats and other animals are frequently used in nutritional science and biology. There is a rigorous approval process, to ensure the least amount of suffering is subjected on to these animals, but nonetheless we do things to animals that we simply would not be allowed to do to humans.
Whilst our biology is similar, of course we are very very different to mice, rats and pigs. You then have our gut differences, lifestyle differences, life span differences, and trying to get the right-sized dose of foods and nutrients that are being tested and significantly smaller creatures.
In Vitro studies involve test tubes and petri dishes, where we try and observe the chemical reactions between various human and nutrient molecules. Like animal studies, these can offer convincing clues on how things may be occurring within a human body, but there are huge leaps of faith taken. As such, hypotheses can be formed with these studies, but for proof we need to observe them in Clinical Trials.
Because of the sheer complexity of Nutritional Science, there is a strong emphasis on peer reviewing studies and papers to ensure sufficient efficacy. But given the almost unlimited nature of performing these trials and observational studies, and the incredible bio individuality of humans as well as their lifestyles, one test if not enough to reach an unequivocal conclusion.
So, it’s common for RCT’s to be repeated by other researchers, to make sure there was no bias involved, and that the results are indeed repeatable.
However, that still in not convincing enough. So, it is very common to perform Meta Analysis. The idea being to take a number of studies that test similar causes and effects, and see through systematic review and number crunching if these different studies reach similar conclusions.
In theory, this is a great idea, as we look to crowd source the scientific results of the past to spot correlations and trends, all without having to perform any extra clinical tests.
But, Meta Analysis comes with its issues. If you take 10 poorly controlled studies, or studies that had very weak confidence ratings of their conclusions, or studies whose correlations were weak, then you will not create a particularly valuable master report. You can’t upcycle poor studies/results into something more convincing. Yet… this is done much more often than you think.
Bias & Money make matters worse
Ok, so that’s a basic introduction to Nutritional Science study formats. as you can see, we’re dealing with a complex beast, and none of our modes of study are particularly great. We’re doing the best with what we’ve got, what we can afford, and what is humane.
But the story gets worse.
Bias is rife in Nutritional Science. Not to suggest the space is full of intentional manipulation, but bias absolutely will effect the direction and design of a study, as well as the data analysis, and the conclusions made.
You have academic bias, which is the world view that the researchers and authors have about all manner of things. If they have flawed underlying knowledge of certain matters, they use this flawed understanding to interpret their study. They may also have a lifestyle or ethical bias, which is hard to neutralise in research.
Then you have institutional bias. Such as the institutional understanding of cholesterol, heart disease, metabolic syndrome and diabetes. There is ego, money, pride and many other consequences to being proved wrong about ‘facts’ that have been shared with the public. This influences what is funded and how things are done.
You have political bias, which is similar to the above, but now you have the interests of a nation and the feeding of their people and ultimately GDP. Again, what gets funding can and does influence what observations and conclusions can be made.
Then you have industry bias. It may surprise you to know that a large percentage of Nutritional Sciences funding is from the Food Industry and Pharmaceutical Industries. Their motives are clear – they want to green light their products and/or address public concern. There is nothing wrong with that, but let’s be straight – these companies will not knowingly fund studies that have a high chance of causing concern for their products or business.
Still Feeling Convinced About Nutritional Science?
Sounds like a mess right? It is, and it’s a relatively new science. A science that has come on leaps and bounds over the last few decades as technology has allowed us to test more things within the body.
However, we’re nowhere near being confident. Just listen to well-respected leaders in the space of Nutritional Science and they will openly admit how little we actually know at this point. We have lots of theories, some of which are competing, but no definitive position. This is because of the complexity of the human body, our bio individuality, and the unlimited nutrient combinations in our diets.
Of course, not all is lost, nor should you lose all trust in Nutritional Science. That said, you need to look through a pragmatic and broader lens…
Show Me The Study!
In part, the motivation behind this article was to address the increasing nature online for certified nutritionists, diet zealots or armchair nutritionists to debunk any argument with the response… “Show me the studies that backs up your point”.
What’s the motivation? Are they even equipped to fully understand research papers and are they genuinely interested with an open mind for their world view to be altered? Or, are they just trying to win the argument by appealing to the authority and blind trust we give to science?
Are they genuinely interested in the truth, or do they just want the other person to do a bunch of work to find and share the studies, only to dismiss them without reading them? Or more likely, are they betting that the other person won’t put in the work to meet their request?
Or do they take another tack? Do they instead try to win an argument by sharing with you a bunch of media links and technically written papers and summaries from PubMed, in the hope that the mere presence of the links is enough to prove they are right – irrespective of the quality of the study and it’s conclusions?
Is this behaviour truth-seeking, or is it just about winning a debate and converting people to their diet dogma? Is it a convenient rebuttal to always say “where are the studies?”, whilst ignoring the very weaknesses with studying Nutritional Science?
In my experience, it’s sadly mostly about wining the argument…
So How do we make up our mind?
Whilst we may not have sufficient confidence in Nutritional Science, that doesn’t mean that no other evidence and nutritional insights exist.
You have clinical observations from progressive partitioners around the world, who are challenging the institutional paradigms and sharing their findings online and within their professional communities. This is very apparent in regards unpopular dietary protocols such as Fasting, LCHF, Keto and even Carnivore.
You have hoards of read-world anecdotes and data from citizen scientists and n=1 experimenters. Yes, these are isolated observations with minimal control, but there are forums with 1000’s of people reporting similar benefits and disease reversals with various dietary interventions. We can’t ignore large bodies of anecdote.
You have ethnographic anthropology, which is about studying populations globally that have different dietary styles to the west. In particular, the studies of indigenous tribes that have been minimally westernised offers a direct comparison to the modern diets of today, as well as their relative disease burden.
You have our ancestral relationship with food, spanning not just modern times but back into our early history as homo sapiens. There is some great technology and archeology that can infer with high degrees of confidence the diets of our early ancestors. If in doubt, looking through the lens of our evolutionary past can give strong clues to what we thrived on as a species over the 100’s of thousands of years, and even millions of years.
Then you have Nutritional Books. Some respected, educated and medical professional leaders have written incredible books on sub-topics of nutrition. They have obsessed about their area of specialism, and dedicated large chunks of their lives to researching, correlating, testing, treating, hypothesising, and self-evaluating. All in the spirit of finding new answers and explaining technical stuff in understandable ways. Of course there could be bias, most certainly citations of studies of varying quality, and they could have arrived at the wrong hypotheses.
Lastly, but perhaps most importantly… is how you feel long term with the dietary and lifestyle choices that you make. Being honest with yourself, do you feel alive, vibrant and disease free? Are you energised, positive and robustly healthy? Or, are you ignoring issues with your body and mind due to dietary dogma or personal preference?
You need to appreciate the full body of evidence, which of course includes the Nutritional Science, but not solely this unavoidably flawed science.
You need to have a critical yet open mindset. An ability, without bias, to evaluate these various sources, look for weaknesses, not blindly accept everything you read/hear, and come up with a conclusion that makes most logical sense. Then, you need to honestly evaluate what works… for you.
Hypotheses will ALWAYS come before scientific evidence
I want to leave you with this final thought.
Hypotheses will always come before sufficient scientific studies – whose aims are to prove or reject the hypothesis. That’s science.
In Nutritional Science, it’s easy and quite frankly lazy to dismiss a hypothesis or dietary suggestion because there is insufficient RCT’s to back it up.
That’s short-sighted. It’s a game of chicken and egg. Everything has to start as unproven… until science catches up.
What do you do in the interim? Rely exclusively on what could be outdated and wrong nutritional conclusions? Recommendations that could be ruining your health or limiting your potential?
It’s your body. Your life.
You don’t have time to wait for some of the mess in Nutritional Science to be cleaned up. Of course, please don’t be be gullible or reckless – but also don’t not rely on the weakest of scientific disciplines to dismiss any and all reasonably minded observations.
Enjoyed the read?