Dr. Tim Says...

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The science behind the DASH diet, an overview: Part Two 08/01/16
The science behind the DASH diet, an overview: Part One 07/25/16
How the Standard American Diet (SAD) affects the brain (Part Two) 05/26/16
How the Standard American Diet (SAD) affects the brain 05/23/16
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Chef Tim Says...

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Dr. Tim Says....



Trust: An Editorial

It's hard to know who to trust. There is so much information about diet, weight loss and nutrition out there. Much of it is pretty silly and a lot is downright dangerous. As you know I try to provide you with the best, evidence-based information. We base everything we do at Dr. Gourmet on the most up to date research available.

I rely on my colleagues at peer reviewed journals to provide that quality information, and I work to translate that for you so that you can both understand it better and put it to practical use in your day to day life. You may have noticed citations and recognize some of the journals that I draw information from. I read everything from the Annals of Internal Medicine to Appetite to the Journal of the American College of Nutrition. Every week these journals push their tables of contents into my email box and I read dozens of articles each month. I rely on these folks being unbiased and scientists being honest.

For the most part this is the case although there have been clear violations of that trust. I do have concerns about whether researchers might falsify or be biased about their data. I follow a number of web sites that monitor this. My favorite is Retraction Watch.

A very reasoned journalist, Ben Goldacre, can help you understand science and how it is often perverted by researchers as well as those who seek financial gain (and some who are simply don't understand).

I do have concerns about the close relationship between journals that I read and their sponsors. At this time there is no great way for us to monitor this although there has been good research showing that there is bias in that relationship. Here's one example: "Pharmaceutical industry sponsorship and research outcome and quality: systematic review." The Council of Science Editors has a position paper on this as well.

Oils and Fats HandoutWhich brings me to the organization that I belong to, The American College of Physicians. While not a journal, they do publish The Annals of Internal Medicine, a journal whose articles we have reported on numerous times here at DrGourmet.com. During some of my noodling about on the ACP web site I came across a handout that aroused concern: "Oils and Fats: What You and Your Family Should Know." The College mailed the patient handout to me and while it may have been published with the best of intentions, the information appears to be slanted toward the sponsor, CanolaInfo.org.

Worse than that, the handout advises that one should keep "total fat intake between 20 – 25 percent of total daily calories." We now know that this is wrong, wrong, wrong. (The best information we have now indicates that your total fat intake should be between 35 and 40% of total calories.)

So who should you trust?

1. First and foremost, those with no sponsorship ties to industries whose products they might promote. It can be difficult at times, because accepting advertising is a reasonable practice, but when this bleeds over into promoting a product through use of a respected editorial platform, that is not acceptable. It is also not acceptable to continue to allow that promotion when the data proves it incorrect.

2. HON Code certification. While this is not perfect, it can help you somewhat. It is a set of guiding principles that are voluntarily adopted by web site publishers. I have, however, seen famous sites with HON Code certification who violate the principles, so use this as a guide only.

3. Look for citations. If someone makes a claim, make sure that they back it up with some research that has been published in peer-reviewed journals. Look up the citation for yourself. Most journals will let you look at least at the abstract online and many will allow you to review the full article. Author disclosures of financial interest are required by all reputable journals now.

One of my colleagues, Elaine Hicks, has a great way to evaluate web sites. This is the COCOA-A method adapted from work by Robert T. Blanchard and Amy K. Blanchard:

C—Currency: When was the website last updated?

O—Outward appearance: Is the site attractive? Does it load quickly? Is it easy to use? Does it inspire your confidence?

C—Coverage: Is it easy to tell what this website covers and doesn't cover? Is it searchable?

O—Objectivity: Is the site objective? Is it trying to sell or persuade you? Does it present both sides of an issue?

A—Accuracy: Does the content seem correct based on what you have previously known?

A—Authority: Who created the website and what are their credentials/qualifications?

Even with these methods it's easy for folks to mislead, and that's exactly what the American College of Physicians has allowed by selling their good name to the canola oil industry. Be wary when you see an industry partnering with any reputable organization. Make sure to ask yourself if the information is truly objective. As in this case, it is often biased.

Eat well, eat healthy, enjoy life!

Timothy S. Harlan, M.D.
Dr. Gourmet