Contradicting Recommendations With New Research

17 years.

That's how long it takes primary source research to become standard recommended practice. Those 17 years are filled with supporting research, translational research, and development of public health campaigns - bringing the initial findings into focus for the public's use.

Why does it take so long? What about the health behaviors occurring within those 17 years? Do those have an impact on health?

Research is a lengthy process - from initiation of the scientific process, to grant application, to study implementation, to manuscript development, to publication. Before, during, and after publication, the research is subject to intense scrutiny from the scientific community.

Why? Because primary source research drives decisions that determine life outcomes. Prescription drug A or B? What about confounding factors and preexisting conditions? These aspects can be very important when a medical provider is making a decision on a course of care.

But where does (seemingly) less high-risk research come in - like recommending increased antioxidant supplement intake for a patient who may be at higher risk of developing cancers?

At one point in the antioxidant research, the evidence seemed conclusive enough to make an overreaching recommendation: supplement smokers with vitamin C to help prevent lung cancer. Check out this article in The Atlantic for a run-down of what was going on with Linus Pauling behind the scenes and how his grandiose statements altered our American psyche.

In 1999, research stated that there was not enough research to recommend antioxidant supplementation, but rather non-smoking and fruit and vegetable intake was the best course of action.

Where does this leave the public? We have a double Nobel-prize winning scientist telling the world that Vitamin C is the cure-all... but the research overwhelmingly disagrees with him. How confusing - especially when you're hungry and you just want to eat normal food.

Unfortunately, antioxidants are not the only nutrient subject to such promotion followed by scrutiny. The jury is often out on meat, then dairy, now gluten, and potentially in the near future: the "free-from" diet, free-from the 8 major allergen foods. 

Bringing nutrition science from primary source articles to pop-nutrtion and media blitzes can be great for health. When the media highlights a well-rounded diet and ways to incorporate more whole grains, fruits, or vegetables, the public benefits.

But when the media focuses on pop-nutrition (nutrition fads that stray from a well-rounded diet), the public can suffer. Primary source articles can be costly, and if found for free, are often difficult to navigate without prior training. Scientific jargon is off-putting, so the public relies on the media and health experts for accurate health recommendations.

Waiting 17 years for accurate health recommendations can seem highly aggravating. What to do in the meantime? Base decisions off of primary source articles with very large sample sizes, over a long period of time (think years rather than weeks), and those that are supported by other well-designed primary source articles.

An example of well designed research: The EPIC studies. The researchers did not jump to conclusions; they took their time and came up with reliable conclusions. Their sample size is the largest in the world

Although good research takes a long time, the best recommendations come out of it. It can be frustrating, but bear with it. Your health is not worth the risk from unsupported research.



Kate Fossman, RDN, LD

October 19, 2015