I’d like to take this opportunity to reflect on how we in the health media communicate about the topics, trends, and research that we cover—and why it matters.
Those of us who write and speak about health have a responsibility to balance the doctrine of personal responsibility with the acknowledgment that poor health is not always the result of poor choices.
Nutrition Diva is hosted by Monica Reinagel. A transcript is available at Simplecast.
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Hello and welcome to the Nutrition Diva podcast. I’m your host, Monica Reinagel and this is the final episode of 2022. And I’d like to take this opportunity to reflect on how we in the health media communicate about the topics, trends, and research that we cover—and why it matters.
One of the challenges that I face in covering nutrition science is putting “breaking news” into a larger context so that you can put it in perspective.
Despite the tendency to position every new development as a breakthrough or game-changer, the truth is that nutrition science (and, really, most science) moves incrementally. New findings may add more data points that confirm a prevailing hypothesis. Or, just as often, the results of an experiment or analysis require us to re-examine or refine our previous conclusions. If you’re someone who likes absolute certainty, cut-and-dried conclusions, and unambiguous outcomes, you’re likely to find nutrition science somewhat frustrating.
Contributing to this is the role that the media play now in the scientific process. These days, experimental results aren’t just published in scientific journals for other scientists to question and build upon. They are also fodder for our insatiable information economy. As a result, a lot of things end up in the news (not to mention on drugstore shelves) before they are really settled science.
Scientific research is expensive and, as a society, we seem to have less appetite for funding it solely for the purpose of expanding human knowledge. We want it to yield products and services that make our lives better and provide some sort of concrete return on that investment. Increasingly, academics and researchers have a mandate to translate their work more quickly into practical applications that benefit human health—not to mention the bottom line.
One result of this pressure is the sensationalization of research results—from press releases that exaggerate findings to popular books that sacrifice subtlety in a bid to land on the best-seller list. Really promising science sometimes gets prematurely hustled into the for-profit pipeline. The direct-to-consumer marketing of things like microbiome and DNA analysis as a means to provide personalized prescriptions for diet and exercise is a great example of this. Although there is no doubt great potential for these technologies, some of these translational research companies have, in my opinion, gotten a bit out over their skis.
So, one of my New Year’s resolutions as a health communicator is to help you put sensationalized research findings and exaggerated claims for products, services, or ideas into perspective. There are very few absolutes or universal truths in nutrition science—and even fewer guarantees. As long as we keep that in mind, there’s a lot to be learned by poking around in the ambiguous gray spaces.
I’m also concerned about the ways in which the role of personal behavior in health outcomes has been distorted.
I think one of the reasons that people are interested in nutrition science is that this is something that we can exercise some control over. Having some control feels good! But we may have lost sight of how much about our health is not modulated via food and nutrition.
We’ve been told that staying healthy is largely about making the right choices. Perhaps this attitude is an inevitable outgrowth of the American ethic of rugged individualism and personal responsibility. It may also have to do with the fact that here in the United States, healthcare is still largely a for-profit enterprise. Highlighting personal responsibility is a convenient way to gloss over the problems with this approach.
Here’s the logic that seems to be at work: if staying healthy is a matter of personal choice, then when you get sick, it must be your fault for not choosing better. It follows that the cost of healthcare is your responsibility. And if the cost of that healthcare is far beyond your means, well, you should have tried harder to stay well.
So, we scan the health headlines for clues as to how we should or should not be eating, exercising, sleeping, thinking, and so on. And when it seems like the advice is constantly shifting or reversing itself, we are understandably frustrated. After all, the stakes are pretty high!
I’d like to suggest that, while personal choices and behavior certainly influence our health outcomes, we may have oversold the doctrine of personal choice as a panacea for public health challenges. Our health is impacted by many things that we cannot control. There’s the lottery of genetics. There are environmental issues, exposure to which tends to correlate with poverty and other structural disadvantages.
These are factors that are beyond our ability to control on a personal level—although they could possibly be addressed at the level of public policy. But right now, the people with the least access to healthcare (preventive or otherwise) also tend to have the greatest exposure to things that undermine their health.
I understand that advocates of “lifestyle medicine” are trying to both empower and inspire people to do the things that we can do to keep ourselves healthy. The unintended consequence, however, is the implication that anyone who suffers from heart disease, Type 2 diabetes, obesity, or even cancer just wasn’t living right. And this is simply not the case.
For one thing, we need to acknowledge that we don’t all have the same ability to make “healthy” choices. But even if we did, you can make all the “right” choices and still end up developing conditions that are frequently labeled as “lifestyle” diseases. This is something that proponents of lifestyle medicine don’t adequately acknowledge or address.
If you are dealing with heart disease, obesity, or cancer, feeling like it’s your fault (or worrying that others might think it is) is not helpful. It may keep people from seeking out or accepting medical treatment—either out of shame, fear that they’ll be blamed or lectured to, or perhaps out of the mistaken belief that fixing their lifestyle will fix the problem. Sometimes, it can’t. But appropriate medical treatment—ideally in tandem with lifestyle interventions—could make a huge difference.
So, yes, we want to educate people about the steps they can take to improve their chances of enjoying a long and healthy life. But we need to do it without stigmatizing those who end up dealing with a chronic health condition.
So, another of my New Year’s resolutions is to temper my advice about healthy behaviors with the understanding that we don’t all (or always) have the same access to healthier choices. As well as to remind us all that the health challenges we (or others) may face are not always the result of bad choices.
In the coming year, I hope you will make the healthiest choices you can make. Perhaps you’ll also join me in looking for opportunities to make healthy choices more available to more people.
With that, I’d like to wish you and your family a happy and healthy New Year.
I’d also like you to invite you to join me for a free workshop on January 3rd in which we’re going to talk about strategies for converting your good intentions into healthy habits. If that sounds like something that would be helpful, you can register at https://weighless.life/workshop