Reliable health information comes from a variety of sources. See Health Information Sources. For the most part, we rely on health professionals and experts to digest and past information to us. Who is delivering our health information? Are they reliable?
Here we explore the quality of the sources. Who should we believe? The question is: which of these ideas are good and not so good, not so bad and bad?
We suggest three criteria:
The table below looks at a variety of information sources in terms of these three criteria.
|Information Source||Independence||Knowledgeable and Current||Expert Judgment|
|You, including your personal experiences and experiences you have come across from those around you||Largely independent, but note the role of personal emotions, addictions, conflicting food and nutrition objectives and ego within you. These undermine your independence.||You are not likely to be knowledgeable or current. Few have the patience or interest in constantly reviewing scientific abstracts and research papers. Beyond this, we all have eating experiences, and over time, the cumulated experiences can begin to give us ideas about what works and what does not. The problem with knowledge based on our experiences is that it is unreliable, because we tend to notice cause and effect relationships only when the effect follows shortly after the cause, and because we are not good at recognizing and isolating all relevant factors that may be involved in a particular effect.||Not likely to have expert judgment.|
|Government, including food guides, research studies performed in-house or through outsiders, expert panels.||Governments cannot be viewed as independent information sources. Can you imagine government bureaucracies advising against, say, eating dairy or beef products. Typically, the role of government is to find a compromise between conflicting interests; this role means intrinsically that the outcome can be subject to bias. Expert panels, where the panelists themselves meet standards of independence and the panelists are outside the bureaucratic and political realms, are the exception.||Government researchers are likely to be knowledgeable and current, but the bureaucratic and government systems typically impose limits on what they can or will say.||Expert panels, where the experts are independent and not selected to bring some corporate or other interest to the discussion, offers some potential to bring expert judgment. A significant problem facing governments is that they are expected to be scientifically fair. In practice, this means that unless a conclusion is 100 percent proven, they have problems presenting the conclusion, because this would be unfair to all the interests that might be affected adversely.|
|Your Doctor||As a general rule, doctors are probably not a great source of food/nutrition information. However, one would expect independence, as your doctor is working for you. In addition, the ethics of the medical profession work to ensure this relationship. They are usually committed to making others healthier.||Doctors have the intelligence and dedication to make it through demanding medical schools. Experienced doctors have had opportunity to see what works and what does not work for their patients. However, doctors are generally not well trained in nutrition. The training received by older doctors would not have included the latest knowledge about nutrition. Doctors in practice usually do not have time to study issues like nutrition that are not directly related to their primary practice. Unless your doctor has specialized in nutrition, your doctor's knowledge may be similar to your own, with the exception that he or she may have read a few articles or attended a few seminars as part of his or her professional development requirements. In short, your doctor may not be a great source of nutrition information. That said, a doctor operating a nutrition clinic may constantly review the latest nutrition research, and would have considerable(anecdotal) patient experience. If that doctor carried out research in nutrition through the clinic, he or she may be at the cutting edge.||Expert judgment requires expert current knowledge. most doctors do not have expert current knowledge in food and nutrition.|
|Your nutritionist||One would expect your nutritionist to provide independent advice. The ethics of professional associations work to ensure the independence of the advice.||Your nutritionist will likely have received much more training in nutrition than your doctor. However, most practicing nutritionists will not have had the time to review the latest abstracts and research related to nutrition. To remain current, your nutritionist likely relies on articles, seminars and course as part of professional development programs. A few may have jobs in research or close to research studies; these few would have knowledge of the current science.||Expert judgment requires expert current knowledge. Most would not have it.|
|Health Professional Associations including associations of doctors, nutritionist, naturopaths, nurses, physiotherapists||They work for their members, who are likely to include your doctor, nutritionist and other professionals.||Most associations serve their members in a variety of ways. Carrying out nutrition research and communications is likely a small part of their activities. Some operate research journals, which serve as a vehicle to disseminate the latest research findings from whatever source. Most operate professional development programs for their members. They have access to the professional expertise of their members. A few may have nutrition researchers who constantly monitor the latest nutrition research.||Some may be able to mobilize creditable expert judgments from among their members.|
|Health Charities (e.g. diabetes associations, cancer societies, heart attack and stroke foundations||Some may be independent. Many adopt strategies of partnering with corporate interests (food producers, pharmaceutical companies) to increase their funding and get their messages to a broader audience. These arrangements affect their independence. Where health charities invest in research, they may have biases toward the research they have funded.||Primary mandates vary. Some charities are research oriented. Others provide services to those afflicted by particular disease and conditions, or who may become afflicted. All would have some access to professional expertise in the areas they deal with. Only the research organizations are likely to have current knowledge in their areas of specialization. Many have narrow mandates (diabetes, cancer, etc.), and as such may not have the required broad spectrum of expertise.||Questionable.|
|TV show hosts and guest "experts"||Since televisions shows rely on advertising, the independence of advice provided through television is questionable.||Show hosts are unlikely to be knowledgeable and current, as they do not have the time to review the latest abstracts and research studies. Guest experts include generalists who are good communicators and find themselves commenting without expert knowledge, and "experts", selected by show producers who likely do not know who are the real experts.||Questionable|
|Popular Book Writers and Documentary Makers||Popular book writers include those out to create a name and commercial opportunities for themselves, and researchers using books to communicate complex issues. The former are not independent. Similar comments apply to documentary makers||Popular book writers are often not knowledge and current regarding nutrition science. Many have neither trained nor worked in the area. Most are story tellers. Popular books and documentaries are not particularly suited to the communication of complex underlying nutrition science ideas, as the story line is not compelling.||Depends on who is writing the book.|
|Youtube Lecturers||Youtube offers a number of health videos. Some videos are organized in a variety of formats: university, conference and meeting lectures; talk interviews, where the show host interviews guests; and presentations, where are host presents material. The independence of the information sources is related to the format. (1) Lectures by university professors tend to be independent. The lecturer Many of these series of shows have large numbers of "subscribers". Guests can include other talk show hosts, as well as others. Mosts hosts make a living through their shows. They can make a living through a variety of mechanisms. They can build commercials into their shows. They can aim to increase "subscribers"; Youtube will insert commercials into their shows, with reimbursement to the show host based on the number of "subscribers". Some shows are supported directly by commercial interests. Others are supported by charitable donations either directly to the show or indirectly through charitable organizations. All these shows are not strictly independent, although their success is determined to some extent by the appearance of independence. A few shows are financially independent. For example, university professor-researchers may use the Youtube videos to increase public awareness of their research. Part of the success of these series is the quality of guests. Many guests are not independent. Some use guest interviews to promote their own show series. Some use guest appearances to promote commercial books. Some use these appearances to promote their commercial products. Some get discounts when viewers buy products from online sellers. While many guests are not independent, one class of guests with some measure of independence is researchers who make their incomes through their research but use guest appearances to make their research findings more widely available. The bottomline is that Youtube show series can range from independent to not independent. One needs to evaluate each show.||Many show hosts and their guests are knowledgeable and current. As a medium, Youtube vides provide can be very current, with the latest science featured on a regular basis. Regarding knowledge, the show hosts and their guests are successful to directly in relation to their ability to present themselves as knowledgeable. However, appearances can be deceiving. The short video medium is challenged to present|
|Youtube Talk Interviews|
|University Professors||While independent in many ways, some rely on corporate funding for their research.||The expectation is that those in the area of nutrition are knowledge and current on nutrition science. Their own research and their supervisory responsibilities for graduate students help keep them current. While they may be individually current, the classes they teach may lag behind current knowledge, as it takes time to develop text books and revise courses. Those professors that produce peer-reviewed studies that end up in nutrition and health journals are the most reliable. Peer-reviewed studies are more reliable than others because experts in the field have taken the time and effort to review the study to ensure is reliability.||They potentially hold expert knowledge. One problem with university professors is that there are incentives to become highly specialized in limited areas of study, rather than generalists with the capability to fit the components together in a broader picture. Expert judgment comes from research integrationist, who look at a wide range of studies within specialized area, determine which studies are more reliable than others, and reconcile different or apparently contradictions conclusions between studies. They also look at the broad results from different areas of specialization, and try to identify conclusions supported through multiple lines of evidence, and reconcile component conclusions that appear to contradict the broader conclusions. Expert judgment is likely to come from older individuals.|
|Corporate Interests, including food processing companies, dairy and livestock producers, paid consultants and researchers, business associations, and sponsored groups||Not independent. They are pursuing their own interests, which may but probably do not coincide with yours.||In some cases, they have considerable knowledge, but experience has shown that they typically communicate only what is convenient.||Not relevant, given their lack of independence and selective communication of their knowledge.|
You have to be careful who you listen to. Clearly, your best source of nutrition ideas is probably not Dr. Oz, or the latest basic researcher explaining his or her most recent results, or your well-established nutritionist, or your doctor. Your best source is someone or some entity that has expert judgment.