One minute it's best to eat ice cream for breakfast; the next minute we shouldn't eat any carbs at all; then we should start drinking red wine every day; then more water; then less water, etc. It's as if we're just a big experiment or some sort of inside joke to the mainstream media.
Lots of things are highly non-obvious. Vitamins weren't discovered until the 20th century. Many baby's lives are improved by their mothers taking folic acid. I would never guess how few calories there are in things like raspberries or strawberries without having been told about it.
Certainly there is lots of terrible health advice, and it's a major issue, telling people to "only read good advice" seems like the worst advice I've ever heard -- obviously we would all only read the good advice if we knew what that was!
The biggest issue for most people is not that they don't know the difference between healthy and unhealthy foods. The problem is to eat the healty foods and stay away from the unhealty ones, which is quite a challenge.
I somewhat disagree. It may be "obvious" to well-informed HN readers. However, I don't think food nutrition is obvious to a significant portion of the population. Proof of this is how the food industry advertises and labels their products to take advantage of buyers' ignorance:
-- orange juice with labels saying that it's "fortified with extra vitamins and calcium". (Many people will associate oj with positive connotations of "fruit", and the vitamin supplement is a bonus. Result: unsophisticated buyers think of oj as "healthy" when it's really concentrated sugar water that will contribute to obesity and tooth decay.)
-- lean cuisine "low-fat" microwave dinners with a "heart healthy" icon on the box. (Naive buyers see the "low fat" as a signal for "healthy" but don't realize that manufacturers have to amplify the taste by adding lots of salt. The heavy carbs in those meals are also controversial.)
-- granola bars and "energy" bars. (The packaging has pictures of active hikers, bicycle riders, mountain climbers, etc. Some granola bars even prominently feature "fiber" as a benefit. The ignorant don't realize that these snacks are really glorified "candy bars" with clever marketing to lessen the guilt trip of eating a stick of sugar.)
-- fat free yogurt. (They took out the fat but now the yogurt has lots of sugar, which is another form of calories, which most people won't burn off, which then gets stored as fat anyway.)
-- photographs of celebrities with milk mustaches shown on billboards and magazine ads and associated slogans like "milk does a body good!". (Those ads are promoted by the dairy industry and it's questionable whether it's healthy for adults to drink milk.)
-- USDA food pyramid. (The uneducated don't realize that the USDA (and hence the chart) is influenced and manipulated by the meat & dairy industries. Because the nutrition advice is officially published by the government and plastered all over school walls, it feels authoritative. Naive consumers don't realize that if the food pyramid was designed by nutritionists not financially linked to meat & dairy, they would place vegetables as highest priority.)
For the consumers that get exposed to nutrition information in a passive way, they really don't know the difference between healthy and unhealthy foods. There's so much misinformation and manipulation that the American consumer is less knowledgeable about what's healthy than the African bushmen eating wild berries and hunting antelope.
Huh? Neither of the food pyramid[0] or its replacement[1] have meat and dairy as highest priority.
Edit: The pyramid that came in between[3] does have milk at a similar size to vegetables, is this the one you take issue with?
[0]: https://upload.wikimedia.org/wikipedia/commons/6/6d/USDA_Foo...
[1]: http://static01.nyt.com/images/2011/06/03/business/03pyramid...
[3]: https://upload.wikimedia.org/wikipedia/commons/thumb/e/eb/My...
Proving your point that this is non-obvious even further, high salt intake may not actually be as harmful as common knowledge suggests:
http://www.washingtonpost.com/news/wonkblog/wp/2015/04/06/mo...
http://www.scientificamerican.com/article/its-time-to-end-th...
Not enough salt is killing more people than too much salt iirc
I'm approximately 81% sure that such marketing is targeted at children and/or their parents.
> granola bars and "energy" bars. (The packaging has pictures of active hikers, bicycle riders, mountain climbers, etc. Some granola bars even prominently feature "fiber" as a benefit. The ignorant don't realize that these snacks are really glorified "candy bars" with clever marketing to lessen the guilt trip of eating a stick of sugar.)
This isn't universally true; there are quite a few brands (like Premier Protein) that specifically advertise low sugar and fat content.
> USDA food pyramid. (The uneducated don't realize that the USDA (and hence the chart) is influenced and manipulated by the meat & dairy industries.
And yet still prioritizes grains, fruits, and vegetables well before meat and dairy (at least until 2005, but my brain still refuses to comprehend the new "MyPyramid" as the One True Food Pyramid, seeing as it completely misses the fucking point of a food pyramid, but whatever). Not that it really matters that much, seeing as how the USDA has (as of 2011) migrated over to the whole "MyPlate" concept, which emphasizes "proteins" instead of meat specifically (and while it does emphasize dairy - with the implication that said dairy is meant to come from a glass of milk - I'd argue that the target audience has generally been children, not adults).
> lean cuisine "low-fat" microwave dinners with a "heart healthy" icon on the box. (Naive buyers see the "low fat" as a signal for "healthy" but don't realize that manufacturers have to amplify the taste by adding lots of salt. The heavy carbs in those meals are also controversial.)
Plenty of "diet" microwave dinners, including those from Lean Cuisine, prominently display low-carb advertising claims. Of course, they tend to swing back to high-fat, but so do most decisions involving the balance of carbohydrates, lipids, and protein.
Also, advocates of the paleo tend to think butter is pretty healthy.
But it doesn't matter, because you can find all kinds of studies that alcohol, chocolate, etc. is healthy. Amount of salt, eggs etc... those are basically all up for discussion. What I'm saying is that for the most part of your diet, it's pretty obvious what's healthy or not.
In my case I've never noticed any issues from dairy products so butter, yogurt, cheese, and milk get some place in my diet.
If there are health benefits to alcohol (and there may well be), I'm sure that adding rum to your coke won't suddenly make the drink healthy.
It's hard to make healthy food choices when your food budget allows for 1 day of nutritionally complete meals or 1 week of macaroni and cheese.
There is even some evidence that indicates that not only is pasture-fed butter better than trough-fed butter, but that regularly rotating the herd to a different pasture every N days is even better. But when the press talks about butter, all butter is the same.
And let's not get started on alcohol... I believe that the current story is that somewhat less than one normalized drink per day is now healthy, and that it does not even have to be red wine.
Do your vegetables have too much oxalic acid, biological contaminants, or residual farming chemicals? Is your fish farmed, or wild-caught (using slave labor)? Is this meat processed just a little bit, or so much that it is now unhealthy? Is this "pink slime" stuff okay, or not? Is this tomato bred for flavor and nutrition, or for uniformity, ease of processing, and visual appeal?
So it's not obvious. It is, in some cases, intentionally obfuscated, to protect business interests.
Most people do have a vague idea of what is healthy, and what is not. But they have no clue when it comes to subspecies, sources, processing, transport, preservation, and preparation.
I know that spinach is a supposedly healthy food. But I have no idea whether there is any significant difference between canned spinach, block-frozen spinach, or bagged fresh spinach. I don't know on an instinctual level whether it is better to sautee it in butter or to bake it in a pastry with feta cheese. I'm not sure where it comes from, or if it is a different variety than spinach grown from seed. Sure, the unhealthiest serving of spinach is probably going to be better than the healthiest serving of gummi bears, but I don't typically eat just one thing when I eat. That spinach might come with a sandwich attached to it, or salad dressing, or barbecued pork, or feta and phyllo.
So it's not always spinach versus gummi bears. Sometimes it's gyros with spanakopita versus pulled pork sandwich with side of greens. I literally have no idea which of those two lunches is healthier, or even if the same lunch plate from different restaurants will have a similar healthiness profile.
The only way I could possibly keep track would be to have a digital assistant that is able to automatically evaluate everything I might put in my mouth and give a recommendation for a healthier alternative that isn't so far from whatever it is that I want to eat that I will ignore it. If I want a burrito from Taco Bell, I might need a recommendation for a burrito from Los Cocineros Hermanos, rather than the good karma salad from Hippietown Vegan Lunchery.
Thinking for yourself is untenable- we need scientists who are experts in analyzing data to provide specific suggestions, and disseminate those in the media. Unfortunately, there is little consequence to reporting false conclusions, or inaccurate health data, so I don't see any change forthcoming.
Kind of a central problem in democracy, if you think about it.
Of course, this also resulted in the more decentralized power structure relative to Catholicism's. Quite a bit of Protestant philosophy and tendency stems from immediate responses to a perceived-to-be corrupt and exclusive Catholic Church.
I respect a theological scholar or priest's mastery of their religion in the same was as I would respect an ardent nerd's mastery of Tolkein's universe, which is to say it is real respect for studying at length a somewhat internally consistent system of mythology. But no matter how much more that nerd knows about mythology I wouldn't trust his word about how Middle Earth actually existed at some point in the earth's history.
As for politics...well that's a huge can of worms isn't it? I would mention that it's not a politician's job to know about politics, but it's their job to get elected and accrue power. A better analogy for you to make might have been political scientist, in which case I would indeed trust their judgement over my own gut feel when it comes to questions about politics like why so-and-so won the election.
Well, that's the best thing I've read all day.
However, if you look behind the "smokes, you'll see he has a point. I proudly admit that I wouldn't think for myself on situations such as choosing a complex therapy. I know nothing about it; what would I do? Trust the Internet?
That's an irrelevant point: You won't see me advocating against having the patients fully informed and making decisions, after being given "alternatives" and respective pros&cons by their physicians. But what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument.
> This works, because you don't have to an expert on athletes' foot to manage your diabetes well, you just have to be an "expert" of your own case.
I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it.
> And that, my friend, is the definition of individual free-thinker.
Quite a strange definition. But OK: if that's a very important point for you to make, great.
Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision.
I wouldn't discount emotions as being irrelevant for health. Patient involvement is very important in the empowerment process, and the patient is the expert in the ways that physician can never be: [s]he, not the physician, knows that drug A causes his/her skin itch; he, not the physician, cares for the quality of life, etc. And, sadly, you miss the point completely: experts have broad knowledge of the situation, while the "expert" patient knows (with the help of experts, of course, of course, of course) his exact case. And the "thinking" part is not done by physician all the time. Empowered patient does the majority of "thinking", the physician is there for support and information. Physician is the expert systems' knowledge base, while the empowered patient is the expert system doing the "thinking" and making informed/educated decisions.
Edit: e.g. http://www.sciencedirect.com/science/article/pii/S0738399109... (emphasis mine)
>Conclusion
>Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care.
>Empowerment occurs when the HCPs goal is to increase the capacity of patients to think critically and make autonomous, informed decisions. Empowerment also occurs when patients are actually making autonomous, informed decisions about their diabetes self-management.
And this is not a new thing in heathcare either, there is a plethora of articles saying the same since 1994.
There are expert patient programmes http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/...
There are expert patiet groups.
Patient choice is (in the UK) written into law and into Department of Health, and NHS, and Clinical Commisioning Groups, and Trust guidance documentation.
You might want to learn what people mean when they talk about expert patients because it's not going away and you seem to have some misunderstanding about it.
> Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision.
This assumes that doctors are not subject to the same cognitive biases that patients are. But doctors clearly are subject to those same biases. The RCT for knee arthroscopy shows us that.
> This assumes that doctors are not subject to the same cognitive biases that patients are.
I really can't tell how could you reach such conclusion. I just said that the doctors are the ones which hold and present the knowledge, as well as supervise your decision. No mentions. at all, to "patients are biased; doctors are 100% objective".
Again, what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument.
Any sane person wouldn't presume to thing for themselves on the best course of action in treating their cancer, for instance. The same thing goes for nutrition and health.
Talking of context though, I think any individual is capable of thinking for themselves when it comes to how much water a day to drink.
Many people think otherwise: they second guess medical experts using their own engineering or scientific knowledge. Sometimes this "seems to work" but it's not clear that it does so in anything but an anecdotal way. Carefully controlled trials and meta-studies are much more effective.
Unfortunately most Americans don't have access to a quality health education necessary to make that distinction.
What we need to systematic meta-studies that are analyzed and published by geniuses (see the Cochrane Collaboration).
If you are an athlete, of course, things are different; but in that case you should probably talk to professionals, not blindly trust mainstream magazines.
For starters you're exceeding the recommended daily intake of added sugar with one can of coke. No big deal, but if your liver could talk, it wouldn't be happy. Your blood pressure rises, again no big deal, but still not good.
The only good thing is the water in the coke.
Before you are two conflicting research papers. One says eggs are bad, the other that they are good. One paper came from The American Poultry Society, and the other from The Poultry Research Institute (those are made up names for the sake of argument). One of those organizations is full of industry shills, and the other is actually doing legitimate research. Every few years, they release papers which contradict the another, in an endless arms race.
The problem which the consumer is faced with is: which is which?
Dr. Michael Greger does this at http://nutritionfacts.org/.
1) Publish whenever there is a single study.
2) Be overly dramatic in either direction.
What we need is for a Bayesian-oriented medical doctor to spend a bunch of time keeping up to date on the literature, especially meta-analysis of multiple randomized controlled trials and then give that information to us with appropriate context. Luckily, this exists:
A YouTube channel called Healthcare Triage: https://m.youtube.com/#/user/thehealthcaretriage
EDIT (thanks mmorris!) https://www.youtube.com/user/thehealthcaretriage
A psychiatry (among other things) blogger called Slate Star Codex: http://slatestarcodex.com/2014/06/16/things-that-sometimes-h...
The former depends on donations through Patreon: https://www.patreon.com/healthcaretriage?ty=h
It's a sad state of affairs, I know, but you simply cannot trust mainstream media for this. If a compound that - per chance - exists in beer is discovered to influence lipolysis in vitro , then mainstream media will tell you to drink a beer to get lean. And it's not only mainstream media fault; universities and research centres PR departments will probably report it in the same way, under the disguise of "making it friendly to the average Joe".
This doesn't mean, however, that you should strictly "think for yourself". Of course, you're not supposed to follow everything blindly, but if you're not an health expert (or even if you are!), It's better to trust authoritative sources and your physicians.
Can you trust them for any real information? In my eyes mainstream media is there to tell stories. Oftentimes bedtime stories for sheepwalkers.
But the truth (TM) - well whatever that may be, I do not see it in media. At least not very often.
Regarding the "trust your physician"-part: I would even take their advice with a very big grain of salt. At least looking at my own experience and the experiences of my significant other in this regard. (And I know, anecdotes not evidence.)
Thing is... "which" grain of salt? Physicians fail frequently, but what's the alternative? I wouldn't know what to question, and on which basis. I could read about it on the web, but why would I trust a strangers report instead of a flawed, but at least "certified", physician?
Before that you could read a lot. Some studies, some literature. A lot will be on the strange to the bullshit-level. But the self-experimenting part will teach you, what is good for your body and what not.
For example one of the problems we face in this field seems to me, that we do know so little about the bacteria (and so on), we have in our intestines. There is quite an active field of research and a lot is happening there. Maybe some day we will know more, coming from this part of science.
Untill then, living with a significant other who had to listen to her body for 15+ years, I for example learned, that reducing my intake of carbohydrates (and esp. sugar and wheat) helps a lot in reducing my weight, while the reduction of fat does not help that much (Every time closely watching my caloric intake).
But I would not recommend doing exactly this to everybody - it is something, that subjectively, anecdotally works for me.
A diet is a complex set of variables. I could look at it holistically, ignore individual variables, and try to make sense of it as whole but a) there's more to health than body composition (such as %BF); and b) I wouldn't like to assume that I can read a blood work panel and interpret it as a physician.
It's not that I don't do this: I work-out daily, I weight and measure myself daily and I also track everything I eat. However:
a) I won't stop getting checked out by competent professionals, so I still put my main trust in physicians; and
b) I can't assume that my "diet experiments" are innocuous. Our bodies, as systems, are way more complex than the systems we engineer. We can't really predict the interactions between all the variables we experiment with (and are subject to). What if I seem OK by now with my diet choices, looking at what you mentioned + my subjective well-being, but end up developing something bad in the medium/long-term? Then I won't be happy with my experimentation. :)
> Before that you could read a lot. Some studies, some literature. A lot will be on the strange to the bullshit-level. But the self-experimenting part will teach you, what is good for your body and what not.
I also do that, quite a lot. I also took a few MOOCs. But I wouldn't say I fully understand what I read, or assume I can interpret a paper in health sciences. It's research-level material, meant to be read by people from the field. I have a PhD in other scientific area: I wouldn't expect someone from other field to make full sense out of a article in my field, so why would I assume I could?
> But I would not recommend doing exactly this to everybody - it is something, that subjectively, anecdotally works for me.
My point is, although I can fully relate (because, well, that's what I do), I'm not able to say "it works for me". It seems to be working, but if I'm scientifically unable to say "it works" without some degree of certainty in my field, why would I do so in a field in which I'm ignorant?
(Your choice of media will determine how much extra value in terms of checking, discrimination etc is added to the news you see reported)
But they like telling you to forget what you know and take on board $newfact because it is easy copy (scientists say so!) and it gets pageviews/sells papers.
I'd argue that as long as someone has no eating disorder (lucky you), eat whatever you want whenever you want and I'm pretty sure you'll be fine.
The problem is rather that almost everyone seems to have some kind of eating disorder. If you can't stop eating or hate to eat (because of time, because of your self image or whatever), that's a different problem then the question what's healthy and what not. Eating healthy won't fix the eating disorder. But thinking too much about what you are suppose to eat, when you are suppose to eat and how much makes it arguably much more likely to develop a eating disorder.
In the case of water, I don't know of anybody who has ever advocated drinking very small amounts of water; the dispute is over how much is enough. It's just a tricky bar to set. Not because we disagree on the benefits of good hydration, but because daily water needs are extremely variable and the color of your urine is about the only practical way to measure hydration.
It's also both simple & valuable to hydrate. At least for me, nothing has made a bigger difference in my condition.
Saying that people should "start thinking for themselves" is disingenuous I believe. For one, this is how we get shit like faith healing, homeopathy, healing crystals and so on. "Normal" people don't have the resources to test a hypothesis, nor the time in most cases. Say you have cancer. What's better? Thinking for yourself and eating a naked mole rat every day for dinner because "they don't get cancer"? Or read some reports and research that apply to your case, and go to a doctor armed with some extra information that will help you both make an informed decision about a treatment?
The problem lies entirely at the feet of the media. Lack of scientific training and a desire to create interesting, attention-grabbing headlines makes for situations exactly what you're complaining about. But this is no reason to eschew science. Science is doing what it does: conducting studies that only test for the smallest amount of variables as possible. It'll be a long time before science will be able to perfectly say "a human of type foo must live exactly like this to achieve maximum potential in life". This is a huge ever-changing puzzle, and while we might have the edges built (my grandma taught me you always put the edges together first) we don't even have all the pieces out of the box. Science finds a piece with a tiny flower on it and the media happily exclaims the puzzle is a picture of a garden.
No, not entirely. You assume scientists are objective and have no agenda. A lot of research is "sponsored" by corporate interests. The first paragraph one should read in a research report is the "source of funding" disclosure, then adjust for bias (or ignore entirely).
So yes, this is more of a shared problem, but the media has let us down here, too.
I agree, but that ship has sailed a while ago :-( Traditional, corrupt and/or click-baity journalism is slowly being replaced by guerilla news sites (such as Drudge, ZeroHedge, etc.), but I am not aware community-driven scientific paper review sites (i have not been looking much, though)
Considering the amount of 'bad' science about (poor quality studies or those with an agenda) I think there's a lot to be said for common sense. Good quality food, as close to its natural form as possible, eat it in moderation and exercise accordingly.
I bet naked mole rats taste great. I wouldn't hold it against anyone.
That said, the problem runs even deeper than what you indicate: "mainstream media" (and even not-so-mainstream media) also tends toward things like faith healing and magic crystals and "a $GEOLOCATION_RESULT mom discovered this one stupid trick and doctors HATE her!" because humans are enamored by the extraordinary and tend to give extraordinary things undue attention. It's rare to find a news organization that doesn't fall victim to this for the simple reason that they are run by humans who - more often than not - have difficulty identifying and addressing such biases, and in turn inadvertently pass them on to their readers and viewers.
This is the same reason why Peter Popoff - despite having been uncovered as a fraud decades ago - is still in business, getting paid programming on the Discovery Channel while selling "Chernobyl water" that's probably from some tap in Odessa, TX. Humans crave the extraordinary, and when they don't, they crave wealth.
Just listen to your doctor, or research medical papers yourself.
In any case, your point doesn't say anything about the healthiness of carbohydrates.
There's evidence (sorry, I don't have the citations in front of me) to link carbohydrate intake to increased triglycerides, higher HDL, and more inflamation - pretty much the opposite of "healthy". OTOH, there's reason to think that a low carb, high fat, moderate protein diet may improve lipid profiles, and reduce the risk of heart disease.
Now, I can't say with certainty that a low carb, high fat, moderate protein diet is better (or worse) than a high carb, low fat diet, or a high protein diet, etc. And I think part of the problem is simply that when you talk about human health and the connection between health and diet, there are just too many variables, and it's hard to control for them all. Hence the fact that you can find research endorsing a number of different diets, which appear diametrically opposed to each other.
A high fat diet increases HDL. If a person is overweight their HDL may drop if they experience weight loss, but it will not drop as much as someone who is on a plant-based diet. About 75% of the people who die from coronary artery disease have what is considered optimal cholesterol. Your cholesterol has to be much lower than what is considered optimal to lower your risk.
http://www.pcrm.org/health/health-topics/cholesterol-and-hea...
"On July 21, 1990, The Lancet published the findings of Dean Ornish, M.D., who demonstrated that heart disease can actually be reversed without medicines.13 Until then, most doctors were not even attempting to reverse heart disease, even though it was, as it is now, the most common cause of death. Most believed that the plaques of cholesterol and other substances that clog the arteries to the heart would not go away. The traditional way to remove them was to wait until they became severe enough to warrant a bypass or angioplasty.
At the University of California in San Francisco, Dr. Ornish tested the theory that a more potent diet, along with other lifestyle changes, might actually reverse heart disease. He selected patients who had plaques that were clearly visible on angiograms and split the patients into two groups. Half were referred to a control group in which they received the standard care that doctors prescribe for heart patients. The other half began a vegetarian diet in which less than 10 percent of calories were contributed by fat. They were also asked to begin a program of modest exercise and learned to manage stress through a variety of simple techniques. Of course, smoking was not permitted.
Dr. Ornish’s patients started to feel better almost immediately, and continued to improve over the course of the year. They had previously been struggling with the crushing chest pain of heart disease, but “most of them became essentially pain-free,” Dr. Ornish said, “even though they were doing more activities, going back to work, and doing things that they hadn’t been able to do, in some cases, for years.”"
But there are so many different diets and so many conflicting studies, it's hard to know what to do. For me, I'm leaning towards going on the ketogenic diet, but I'm waiting to meet with a local doctor who specializes in that, before making a definite decision.
http://www.ncbi.nlm.nih.gov/pubmed/9805219
I don't understand why you would pick a diet that is known to raise LDL levels when Dean Ornish and Caldwell Esselstyn are using a plant-based diet to treat those with cardiovascular disease with great success.
The keto diet is actually known for improving lipid profiles, especially in terms of increasing HDL, lowering LDL particle size, and lowering triglycerides. Some people do see their total cholesterol go up a bit, but the thinking is that HDL/LDL ratio and LDL particle size matter more than total cholesterol count.
But, for me personally, I haven't made a final decision yet. I've read a little on the Ornish diet and am somewhat intrigued by that as well.
At the very least, I think we can all agree that high amounts of processed sugar is bad. :-)