“This is one of the most important articles I’ve ever written. Maybe the most important one in terms of getting this message across to practitioners.” – Alan Aragon
It’s my pleasure and honor to share with you this guest article today by mentor and friend, legendary sports nutritionist and researcher, Alan Aragon. Alan opened my eyes to the shenanigans of the fitness industry and showed me that this job could be a legitimate profession.
This article originally published in his Research Review in March. The gems inside this widely-loved monthly publication usually stay locked away to subscribers, but as I have been the one pushing him to write this for the last two years, he made a special exception. I hope you enjoy it.
Enter Alan…
An Uphill but Noble Climb
It’s easy to picture the lay public as birds on a wire, aimed at by the proverbial snake oil salesmen holding finely tuned sniper rifles and picking them off at will. As professionals and enthusiasts in the health & fitness industry who have a strong appreciation for science (and ethics), this is painful to watch. But, we’re constantly forced to witness the lay public fall face-first for unfounded ideas, products, and protocols. There are people within the industry who think that it’s a waste of time and energy to battle these charlatans and their henchmen. Assuming that these snake oil salesmen proliferate faster than the “good guys” can keep up, is the solution to simply put on a pair of blinders, avoid public critiques or “call-outs,” and simply mind our own business and produce good work? I don’t think so. Here’s how I suggest you go about it.
1. Create Awareness by Speaking Up
As I see it, our job is to not only provide consumers (both professionals as well as lay folks) high-quality, science-based information, but also inform the public of the low-quality, BS-based information. One of the primary ways we can begin to arm the public against the promotion of hogwash is to acquaint them with the skeptical mindset. Some might argue that pointing out the bad info only gives the hucksters more of the publicity that they seek – but to me, this is a necessary sacrifice. High-profile charlatans dedicate a tremendous amount of resources toward marketing, so they’re already getting a ton of publicity. Why not expose the quacks’ audiences to you and your valid counterpoints and genuinely helpful body of work?
Simply informing the public of popular ideas and products masquerading as scientifically supported will create more awareness that, yes, there is a LOT of useless crap out there being shoved down people’s throats. A growing segment of the public will eventually cozy-up to the idea that being more discriminating can spare them lots of wasted time, money, and effort – and also save them from varying degrees of adverse health effects.
Speaking of wasted time, money, and effort (with a side order of adverse potential), a prime example is Bulletproof Coffee, which I’ve covered extensively in the June & July 2013 issues of AARR. Briefly, time and effort are wasted by dealing with the application and clean-up of buttering up coffee, and by necessity, your blender. Money is wasted through the purchase of ‘special’ butter and ‘special’ MCT oil (which does little more than add calories). Those who really fell hard for the pitch bought the ‘special’ coffee, which costs about double the regular stuff. The humor in the latter is that the sales hook is based on an alleged mycotoxin problem, which is practically nonexistent in commercially available coffee [1,2].
As far as adverse potential goes, butter was directly compared with cream in terms of effects on blood lipids. Rosquist et al [3] found that cream, which contains significantly more milk fat globule membrane (MFGM), had no significant effect, while butter raised non-HDL cholesterol, as well as the proportion of apolipoprotein B in the blood. Both of these outcomes are associated with increased cardiovascular risk [4,5]. Apparently, MFGM is the inherently cardioprotective component of cream. The churning process to make butter gets rid of a significant amount of MFGM. Now, this doesn’t make butter some sort of “bad” food to avoid, but it doesn’t offer any inherent benefit to health—especially compared to cream (which, by the way, doesn’t require a blender to mix with coffee).
Don’t Underestimate the ‘Save-Able’ Minority
Of course, a large segment of the public simply wants to believe. Unfortunately, some folks are incapable of, or unwilling to listen to anything but their own impulse and emotion. These are not the people you will reach, but that’s fine. It’s impossible to save the world. However, there will always be a minority of the masses who are both open-minded and intelligent enough to lend an ear to reason. I’ve witnessed this first-hand. Many of my followers and students began as people who in essence got “schooled” by me, either directly or through something I wrote that challenged their beliefs. Now, these individuals function as allies in the crusade against misinformation. The point is that you must operate with the understanding that you will help some, but not all. But those you do save are worth the effort in the long-run.
2. Begin With the Broader Principles, Progress to the Details
The best approach to educating the lay public is to provide a foundation of principles, and provide only as much detail as will allow people to get a sufficient grasp of what you’re teaching. Make sure the length and nature of your message fits the interest level and education level of the listener. In order to not fall for a diet or supplement scam, people don’t need to be scientists, but they do need to have a fundamental grasp of certain scientific principles, and they do need to cultivate a scientific mindset. Given that the person is willing to learn (this can be gauged by a higher asking-to-telling ratio), start by fitting the type of answer to the type of question. People will either have questions about broad concepts that can be met with broad answers, or they’ll have questions about specific products or compounds, to which specific answers can be given. For example, if someone asks what’s the best diet for weight loss, this could be answered in a multi-stage format, beginning with the very simple fact that there is no “best” diet for weight loss other than what the individual can safely adhere to in the long-term, and this involves sticking with the foods you like best while sustaining a caloric deficit from week to week, and month to month.
Ah-hah, did you see that? The audience just learned something new: there is no single diet that will work best for everyone, but ALL diets must somehow impose a caloric deficit over time in order to work. It’s these principles that we professionals take for granted, but amazingly enough, the lay public is largely unaware of these crucial, foundational concepts. In your answer, they are looking for specific foods to seek or avoid, or they’re looking for a specific brand of diet that you endorse or recommend. Absolve them of that nonsense right off the bat. From that point, you can get into details such as the individualization of macronutrition. Once the audience is free from the shackles of believing that a ‘magic’ diet or ‘weight loss foods’ exist, you then can add further layers of education.
Someone more interested in the technical details might ask you about insulin or some other agent that’s received blame in the current crop of popular diet books that erroneously blame a single factor for the rise of obesity. This gives you the opportunity to present a couple of important concepts in science and research as they pertain to quacky claims. The first concept is that oversimplification, combined with speculation, is what sells diet books. The actual facts are boring, and already well-known. No new weightloss or fat-burning secrets are being kept within the pages of the latest bestseller, and people need to own up to this reality. Although good diet books exist, they’re just not gimmicky enough to be runaway hits.
From this point, if your audience is still listening, you can present the concept of evidence. The public is largely unaware of the importance of asking for the evidence behind the claims on the label, in the book, or by the guru in question. When there’s an important (and potentially costly) decision to be made, we automatically ask ourselves why we would or would not choose a given product, path, or person for a given need. Incredibly, we don’t apply that same skepticism or critical thought to decisions we make about diet and exercise. Regarding the birth of self-proclaimed gurus, it typically happens as follows… Since we all eat, the tendency is to automatically assume expertise in diet and nutrition. The same applies with exercise; who ever trains regularly and achieves some impressive stats stands the chance of assuming authority on the topic.
This auto-ordained authority is not as common in areas such as law, engineering, architecture, etcetera, which not everyone has direct and regular experience with. But with diet and exercise, watch out—everyone is an expert. Somehow, formal training and education are not required. Gurus will often dismiss formal education as being solely driven by government conspiracy or ulterior motives of the parent organizations. It’s for these reasons that the health & fitness industry is jam-packed with charlatans. Some of them have good intentions, but all of them chronically spew misinformation, and many only care about one thing: making money. They often preach their gospel with a compelling, passionate tone that captures followers, and the common scenario of the blind leading the blind ensues.
On the surface, this might not seem like a big deal, but unqualified gurus often end up adversely impacting the health of their audiences. The effects can be acute and catastrophic, but in this industry, they’re typically gradual, insidious manifestations of counterproductive habits over time. And it’s for this very reason that the general public needs to apply an evidence-dependent mode of action when navigating and applying health & fitness information. It’s crucial to convey to the lay public that they need to make informed decisions rather than blind decisions when it comes to diet and exercise. Making informed decisions fundamentally involves becoming aware of the evidence basis of the claim at hand.
Educate your audience about what constitutes strong evidence (peer-reviewed, independent replication of results, converging evidence from observational and experimental data, etc.), and thus confidence in whether or not something “works” or is even worth a try. Conversely, the lay public needs to know what constitutes weak evidence (anecdote, tradition, perceived authority), thus warranting a high degree of caution.
For the interested lay person, a simple conversation about the strengths and limitations of experimental versus observational research can go a long way for getting the wheels in their brain turning when it’s time for them to examine the evidence. Another thing to consider is that lay folks are generally unaware that a single study can’t be an almighty game-changer. Rather, it must be viewed as a piece of the puzzle within the context of the larger body of studies on the topic to-date. Other concepts such as statistical versus practical significance, internal versus external validity, population-specific relevance, etc., can be peppered on as interest allows. One of my favorite refreshers on the fundamentals of research in the present context is Using Research and Reason in Education by Paula & Keith Stanovitch (42-page PDF freely downloadable here)[6].
For professionals in the field, as well as non-professionals who are more advanced in their knowledge and appreciation of research, there are several good resources for delving into the various designs and details, which I’ll provide in full-text in the reference list [7-17]. A very favorable outcome, aside from your audience actually learning something, is when they come to the realization that they have more to learn. At least now they have you as a resource in their educational journey.
3. Let Your Audience Guide Your Teaching Intensity & Duration
Those who have presented material to captive, highly interested audiences in a seminar setting must realize that the rules of engaging learners ‘out in the wild’ are drastically different. The most effective way of educating the lay public is to tailor the lesson to the situation – which almost never is a group of people who paid to sit and hear you talk for an extended period of time. Allow the student to ask the questions that guide the extent to which you dish out your knowledge. A common mistake is blathering on beyond what people are willing to hear, and then you lose their attention. Resist the temptation to teach everything you know, all at once. The majority of people who ask questions are looking for simple answers. Again, let them lead the conversation with further questions about the points you make. When they stop asking questions, that’s your cue that your rambling allotment is coming to an end, and you can begin again next time (if there is one).
4. Dissect the BS, not the BS-er
In other words, address the information, not the informer. Immediately taking shots at the beloved guru could get you alienated and prevent you from winning the attention of your audience. We have all been guilty of belittling gurus and calling them all kinds of colorful nicknames, but this does more for making people defensive than getting them in the mood to hear new information, let alone contemplate challenges to their beliefs.
An effective approach is to first address any aspects of the guru’s information that actually have merit. Usually, there’s a certain amount of valid stuff mixed in with the unscientific crap. So, address the claims that have scientific support, and then address the garbage for what it is – of course justifying your counterpoint with relevant research. When people are calmly shown the greater weight of the counter-evidence compared to their beliefs, a period of cognitive dissonance might follow, but those who are open-minded eventually give your position some serious consideration. And some of these open-minded people will modify their opinion based on their new knowledge, which they will be thankful to you for providing.
5. Explain the Limitations of the Lay Media, Provide Alternatives
In our own little fantasy world, every lay person we have an educational discussion with would head straight to the textbooks [18-22] and peer-reviewed literature [23-24], and dive in. In reality, the people we talk to have vastly differing educational backgrounds and interest levels. Only a small fraction of the lay audience will be inclined to delve into the complex, technical stuff. The quacks have a keen sense of this, so they know how to push just the right amount of emotional hot-buttons and sprinkle enough pseudoscientific jargon onto the layperson to make them feel informed. It’s our responsibility to educate the public about the pitfalls of the lay press. It has relatively nonexistent publication standards – no peer review, minimal to zero quality control, and low to no barriers of entry for authors.
We can help prevent this rampant misguidance by exposing our ‘classified knowledge’ of the science-based resources that also happen to be palatable for the lay public.
References
- VD Stegen G, Jörissen U, Pittet A, Saccon M, Steiner W, Vincenzi M, Winkler M, Zapp J, Schlatter C. Screening of European coffee final products for occurrence of ochratoxin A (OTA). Food Addit Contam. 1997 Apr;14(3):211-6. [PubMed]
- Levi C. Mycotoxins in coffee. J Assoc Off Anal Chem. 1980 Nov;63(6):1282-5. [PubMed]
- Rosqvist F, Smedman A, Lindmark-Månsson H, Paulsson M, Petrus P, Straniero S, Rudling M, Dahlman I, Risérus U. Potential role of milk fat globule membrane in modulating plasma lipoproteins, gene expression, and cholesterol metabolism in humans: a randomized study. Am J Clin Nutr. 2015 Jul;102(1):20-30. [PubMed]
- Kaneva AM, Potolitsyna NN1, Bojko ER, Odland JØ. The apolipoprotein B/apolipoprotein A-I ratio as a potential marker of plasma atherogenicity. Dis Markers. 2015;2015:591454. [PubMed]
- Ridker PM, Rifai N, Cook NR, Bradwin G, Buring JE. Non- HDL cholesterol, apolipoproteins A-I and B100, standard lipid measures, lipid ratios, and CRP as risk factors for cardiovascular disease in women. JAMA. 2005 Jul 20;294(3):326-33. [PubMed]
- Stanovich PJ, Stanovich, KE. Using research and reason in education: How teachers can use scientifically based research to make curricular and instructional decisions. RMC Research Corporation, Portsmouth, New Hampshire. 2003. [Full PDF]
- Boushey C, Harris J, Bruemmer B, Archer SL, Van Horn L. Publishing nutrition research: a review of study design, statistical analyses, and other key elements of manuscript preparation, Part 1. J Am Diet Assoc. 2006 Jan;106(1):89- 96. [PubMed] [Full Text]
- Boushey CJ, Harris J, Bruemmer B, Archer SL. Publishing nutrition research: a review of sampling, sample size, statistical analysis, and other key elements of manuscript preparation, Part 2. J Am Diet Assoc. 2008 Apr;108(4):679- 88. [PubMed] [Full Text]
- Bruemmer B1, Harris J, Gleason P, Boushey CJ, Sheean PM, Archer S, Van Horn L. Publishing nutrition research: a review of epidemiologic methods. J Am Diet Assoc. 2009 Oct;109(10):1728-37. [PubMed] [Full Text]
- Research Methodology: full series in the Journal of the Academy of Nutrition and Dietetics, from 2006 to the present. [JAND]
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- Boswell C, Cannon S. Chapter 13: Critique Process. Introduction to Nursing Research: Incorporating Evidence- Based Practice. Jones and Bartlett Publishers (no date listed). [PDF]
- Greenhalgh T. How to read a paper: Full series in the British Medical Journal, 1997 [BMJ]
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- Gropper SS, Smith JL. Advanced Nutrition and Human Metabolism, 6th Edition. Wadsworth, Cengage Learning, 2013. [Amazon]Amazon]
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- Schoenfeld BJ. Science and Development of Muscle Hypertrophy. Human Kinetics, 2016. [Amazon]Amazon]
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- Helms, et al. Muscle and Strength Pyramids [e-books]
- International Society of Sports Nutrition position stands [JISSN].
- American College of Sports Medicine position stands [ACSM].
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