How can nutritional science be made more accurate?

[sanantone]

I'm used to the social sciences having a lot of grey areas because human behavior is complex, but I expected nutrition to be more easily understood because it's based on physiology and biochemistry. I think the problem with nutrition, as with the social sciences, is complexity and individual differences. In my medical sciences program, we learned that looking at stomach contents is a highly inaccurate way of estimating the postmortem interval (time since death) because people digest food at different rates, and different foods break down at different rates. 

As I was listening to an NPR program the other day on diets, I realized that I had to throw everything I knew about nutrition out the window. We've learned that the problems fats and cholesterol cause have been overstated. We've learned that sugars, simple and complex, are a bigger problem than fats. The calories in/calories out advice given to lose weight is bad advice. Different people eating different foods at different times will retain different amounts of calories. A study even found that eating day-old, leftover pasta results in less calorie retention than eating fresh pasta even though the person is eating the same number of calories.

I think these problems are seen all throughout the medical sciences, actually. A lot of medications that were seen as safe have been later found to be dangerous. Not too long ago, I had a doctor recommend melatonin for my sleeping problems, and I told him that I was already taking it, and it wasn't really helping. He was shocked. I was shocked that he was shocked. Melatonin is simply a hormone that regulates your body's clock; it tells your body that it's time to go to sleep. If you have trouble staying asleep, then melatonin may not help. You'd be surprised at how often doctors are following trendy news headlines as much as we do. I won't gross you out with all of the grey areas I've learned about in pathology.

[cookderosa]

My over-simplified assessment is that the biggest problem with nutrition is that everybody eats.
Since everybody eats, it puts the topic in a unique situation for everyone to generate an opinion about food and nutrition - which means everyone with a website gets an opinion. And though you're right that it is physiology and biochemistry, most of what you'll read is generated by people without any knowledge of science, and the real sale comes from selling their spew to people who don't know science either, so it's easy.

I wrote a paper in grad school about The Blue Food Category. It was satire, we were studying nutritional sociology and behaviors/history of. But if you look at SCIENCE-BASED nutrition, nobody cares. Science does a terrible job at reaching the people and when they do, they make the second mistake of believing that people eat based on science. (X calories, Y protein, etc.) This is where dietitians fall short. If you've ever worked with RDs, they are what I'd call "left brained" and very focused on numbers. Facts and stats confuse people and make it hard to remember or learn. Most people don't behave / modify behavior because they learned some facts.

But if you follow the popular culture eating / dieting / consumer trends, they are very "right brained" and appeal to social behaviors and dreams. People eat based on their preferences, cultural norms, emotional feelings associated with eating, joy, etc. and people also use food as a way to control others (ex. parents at mealtime) or as a way of controlling those around them (through disordered eating). Finally, people use food as a political weapon (GMOs, animal rights, buy local) to advertise their position.

I went to culinary school right out of high school, so I've been a foodie since day 1. I'm all about the meal, the event, the social, the joy, the memories, the flavors. And then studying nutrition as a science was very different- it's all about the chemistry, biochemistry, physiology (dry but important). I found that both are firmly planted in their own worlds and give little credibility to the other. IMO, the successful approach will be the intersection of hard science and social science.

[sanantone]

I'm focused more on doctors who, in the past, would advise their patients to reduce fat and caloric intake to lose weight. For the past 20 years or so, doctors have started advising their patients to go on low carb diets instead.

Then, you have conflicting findings in published studies. One study will tell you that artificial sweeteners will not raise your blood sugar levels and another study will tell you that a few of them will. These are peer-reviewed articles!

[ronaldemail1]

On the subject of diet. There is a lot of studies. But there is no pictures of the before and after of a person to sustain those studies.
(I am not taking about the marketing campaigns promoting diet). I just would like to see plain before and after pictures with real
people for every proposed diet. And then a follow up. Why it is so hard ? Maybe they all know that their proposition do not pass
a reality test.

[sanantone]

On the subject of diet. There is a lot of studies. But there is no pictures of the before and after of a person to sustain those studies.
(I am not taking about the marketing campaigns promoting diet). I just would like to see plain before and after pictures with real
people for every proposed diet. And then a follow up. Why it is so hard ? Maybe they all know that their proposition do not pass
a reality test.

Scientific studies don't display pictures of participants. That would be considered unethical. An IRB would never approve that. Plus, these people are often considered patients, so their healthcare information is confidential under HIPAA.

---

Speaking of scientific research, there was a study released several years ago that found that people lost the same amount of weight no matter which diet they were put on. The study had groups of people who were on various diets and even no special diet at all. The constant was that everyone ate the same number of calories. This led the researchers to conclude that cutting calories was more important than anything else.

Now, we have physicians and scientists saying that calories in/calories out is oversimplified and people should go on low carb diets without counting calories.

[ronaldemail1]

On the subject of diet. There is a lot of studies. But there is no pictures of the before and after of a person to sustain those studies.
(I am not taking about the marketing campaigns promoting diet). I just would like to see plain before and after pictures with real
people for every proposed diet. And then a follow up. Why it is so hard ? Maybe they all know that their proposition do not pass
a reality test.

Scientific studies don't display pictures of participants. That would be considered unethical. An IRB would never approve that. Plus, these people are often considered patients, so their healthcare information is confidential under HIPAA.

---

Maybe independent studies with people that allow their personal information to be released (Open Source Style).

[sanantone]

On the subject of diet. There is a lot of studies. But there is no pictures of the before and after of a person to sustain those studies.
(I am not taking about the marketing campaigns promoting diet). I just would like to see plain before and after pictures with real
people for every proposed diet. And then a follow up. Why it is so hard ? Maybe they all know that their proposition do not pass
a reality test.

Scientific studies don't display pictures of participants. That would be considered unethical. An IRB would never approve that. Plus, these people are often considered patients, so their healthcare information is confidential under HIPAA.

---

Maybe independent studies with people that allow their personal information to be released (Open Source Style).

That's entering dangerous territory. An independent group of people should always review research proposals involving human test subjects. Before internal review boards, there were a lot of unethical studies in medicine and psychology that caused harm to the subjects. Besides, most people are fine with just reading the data.

[cookderosa]

I'm focused more on doctors who, in the past, would advise their patients to reduce fat and caloric intake to lose weight. For the past 20 years or so, doctors have started advising their patients to go on low carb diets instead.

Then, you have conflicting findings in published studies. One study will tell you that artificial sweeteners will not raise your blood sugar levels and another study will tell you that a few of them will. These are peer-reviewed articles!

That's simple, if you look up med school curriculum, most only take 1 nutrition course. It's a shame, because they have the scientific knowledge to really do some good- but it falls flat since they aren't really taught. Interestingly, there are some med schools that are integrating nutrition AND cooking into their electives.

[sanantone]

I'm focused more on doctors who, in the past, would advise their patients to reduce fat and caloric intake to lose weight. For the past 20 years or so, doctors have started advising their patients to go on low carb diets instead.

Then, you have conflicting findings in published studies. One study will tell you that artificial sweeteners will not raise your blood sugar levels and another study will tell you that a few of them will. These are peer-reviewed articles!

That's simple, if you look up med school curriculum, most only take 1 nutrition course.  It's a shame, because they have the scientific knowledge to really do some good- but it falls flat since they aren't really taught.  Interestingly, there are some med schools that are integrating nutrition AND cooking into their electives.

There should be more focus on nutrition since that's part of preventive medicine. I've heard the same thing about veterinarians. They don't learn much about nutrition while in school.

[cookderosa]

I'm focused more on doctors who, in the past, would advise their patients to reduce fat and caloric intake to lose weight. For the past 20 years or so, doctors have started advising their patients to go on low carb diets instead.

Then, you have conflicting findings in published studies. One study will tell you that artificial sweeteners will not raise your blood sugar levels and another study will tell you that a few of them will. These are peer-reviewed articles!

That's simple, if you look up med school curriculum, most only take 1 nutrition course.  It's a shame, because they have the scientific knowledge to really do some good- but it falls flat since they aren't really taught.  Interestingly, there are some med schools that are integrating nutrition AND cooking into their electives.

There should be more focus on nutrition since that's part of preventive medicine. I've heard the same thing about veterinarians. They don't learn much about nutrition while in school.

I agree! They are really the "front line" workers when it comes to health. On a side note, my master's thesis was an analysis of every culinary program in the USA. I looked up how many nutrition courses were taught in the program- chefs are also in a significant position to make a difference. The average was also 1, but many programs offered zero. So, you have the people cooking your food undereducated about nutrition, and you have a doctor advising you about health undereducated about nutrition, and an internet full of fads and phony advice. Further, to get access to an RD you have to usually have a prescription from your doctor (or pay out of pocket) and even then, an RD is going to be so hyper-specialized that a lot of people are turned off to the whole experience. I love watching 600-pound life when they meet with the RD. I know they do that to make it dramatic (because it's always a trainwreck) but RDs should see this and learn from it- there are so many moving parts to this problem, that I can't even begin to see a real solution. I left my MS program very very discouraged frankly.