The document discusses how nutrition discussions on social media often become heated due to exaggerated or oversimplified claims made by various groups. It provides examples of how a single study on the link between sugar and diabetes was oversold by academics and media. This led to simplistic views being promoted despite contradictory evidence. The document advocates using stronger evidence hierarchies and acknowledging shades of gray in the scientific literature rather than making black and white claims to improve nutrition discussions.

1. Diet discussions in the social media –
A dietician’s view
Presented at 8th World Congress of
Science Journalists
2013, Helsinki, Finland
[Updated December 2014]
Registered dietician, M.Sc, MBA
Reijo Laatikainen
www.pronutritionist.net
www.pronutritionistblog.com www.twitter.com/pronutritionist
Page 1

2. My view is based on participation
• Posted more than 500
posts at different 4 blogs
• Engaging in discussions
in Finland, US, UK and
Australia
• Follow nutrition literature
• Meet patients regularly
2

3. Why do discussions on diet heat
up?
These are my personal views

4. 4
Academics
Media
Individualism
Dieticians and
nutritionists
Interest groups
(low carb,
vegans etc.)
Too often black & white,
sluggish to admit mistakes
& overselling own studies
Selling news & hunting
clicks is rife in some
media.
“I’m the best expert on
my health”
Dieticians are often absent
or cautious. Stand up for the
discipline, as a profession!
Cherry picking, ridiculing &
dismissing opposing data
as a chosen strategy
✔
✔

5. I’ll only focus on two of these.
Nutrition authorities and media,
because …
It’s certainly true that some prominent low
carb, vegan, paleo & other diet proponents
cherry-pick data, dismiss opposing studies
and ridicule ”opponents”. However, this is so
obvious that I don’t find it particularly
interesting.

6. 1.
Public health messages cast by
nutrition authorities are
exaggerated or simplistic
6
Shades of grey. It is risky to oversimplify science for the sake of a clear
public-health message. Nature 2013:497; 410 (editorial)

7. How a single ecologic (correlation)
study becomes the ultimate piece of
evidence
• Professor of Pediatrics in the
Division of Endocrinology at
University of California, San
Francisco
• Eagerly praised and followed by
low carb and paleo communities
7

8. Sugar usage was linked to incidence of
type 2 diabetes in an ecologic study
8
Correlation of sugar availability and type 2 diabetes worldwide
Basu S, Yoffe P, Hills N, Lustig RH. The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric
Analysis of Repeated Cross-Sectional Data. PLoS ONE 2013; 8(2): e57873

9. Press release

10. 2.
Media spices up the story and
oversells the outcomes
10

11. Mark Bittman, NY Times stretches
Lustig’s findings further…
11
• ”The take-away: it isn’t simply
overeating that can make you
sick; it’s overeating sugar.
We finally have the proof we
need for a verdict: sugar is
toxic.”
• ”Obesity doesn’t cause
diabetes, sugar does”.

12. New York Times
(It’s sugar, Folks 02/28/2013)

13. 13
8 days later, a correction appears

14. But who reads the correction
anyway?
Damage is done and one dogmatic
view is facilitated.

15. Simplistic and exaggerated
Example 2, read here
(was not presented)

16. This is how it often goes when
conclusions become distorted in
media and in a population.

17. Media and academics do each have their role
and cannot accuse only the bad behaving in
social media
4 Opinion,
comment,
blog
2 Press 3 News
release
1 Scientific
paper (article)
Authors
present
results
University
sells the
story
to media
Media
sells the
story to
people
Someone
further
exaggerates
and modifies
data/context

18. Furthermore, there truly is
contradictory data in the field of
nutrition.
It’s rarely black and white.

19. Example 1
Cancer and diet in cohort studies

20. Sometimes variety of results is
very broad (cohorts)
Schoenfeld & Ionnidis. Is everything we eat associated with cancer ? A systematic cookbook review, Am J Clin Nutr December 2012
ajcn.047142.

21. Example 2
read here (not presented)

22. Hierarchy of evidence is usually not
well articulated or appreciated →
Surrogate/cohort/mice studies tend
to get equal attention as randomized
hard end point studies and meta-analyses.
Media embraces contrary results.
→
a mess
22

23. One step forward?
Lets’ use the ranking tool for
evidence. It’s been around for
long.
23

24. 1. Randomized mortality &
morbidity trials
2. Prospective cohorts
3. Randomized risk
marker studies
4. Cross-sectional and
case-control cohorts
5 Ecological & animal
studies
Strength of evidence
Meta-analyses of 1,2 & 3
Modified from: Micha & Mozaffarian.
Lipids. 2010; 45(10): 893–905 and
Evidence Analysis Manual.
Academy of Nutrition and Dietetics
January 2012

25. Let’s face it (despite our best
effort):
There will always be media which
do not seem to care about the
”truth” but rather focuses on
exploiting debates
25

26. Low Carb Diet
26
Good Diet Bad Diet

27. My two hopes for both media and
nutrition authorities.
Less black and white statements
and less focus on selling.
Page 27

28. One more hope.

29. Let’s stop accusing short-sightedly
the “bad” people across
the border (low carb/paleo
advocates, vegans, super foodies,
dieticians, authorities, university
press officers etc. )
Let’s clean up our own behaviour
and language too.
Page 29 www.pronutritionist.net

30. “Everything should be made as simple as
possible, but not simpler”
Page 30

31. Recommended readings
• Hughes V. The big fat truth. Nature 2013:497;428–430
• Shades of grey. It is risky to oversimplify science for the sake of
a clear public-health message. Nature 2013:497; 410
• Sumner Petroc, Vivian-Griffiths Solveiga, Boivin Jacky, Williams
Andy, Venetis Christos A, Davies Aimée et al. The association
between exaggeration in health related science news and
academic press releases: retrospective observational study
BMJ 2014; 349:g7015
• Goldacre Ben. Preventing bad reporting on health research
BMJ 2014; 349:g7465

32. Wellcome aboard!
http://twitter.com/pronutritionist
http://www.facebook.com/pronutritionist
http://www.pronutritionist.net
Reijo Laatikainen, registered dietician, MSc, MBA
Images bought and licensed from BigStockPhoto. Snapshots from papers and sites refered to.
Page 32