By Kate Jacobson | July 13, 2020

When it comes to nutrition, there are a million different recommendations, fads, trends, and opinions. But are they all based on evidence? How do health practitioners differentiate between fact and fiction?

In an upcoming AACVPR webinar, Joel Hughes, Ph.D., FAACVPR, and Karen Collins, MS, RDN. FAND, explore why cardiopulmonary rehabilitation staff—including registered dieticians—need to critically evaluate the claims made in the media, by research literature and by the experts, both for their patients and themselves.

“Some of the most pervasive messages aren’t really based on evidence,” Hughes said. “What we do as a shortcut is to try to trust the experts and authorities we think are telling the truth, but there are a lot of credentials out there. How do you know who knows what they’re talking about?”

Using Critical Thinking and Understanding Bias

Every day we see new information coming out about how our bodies react to different foods or diets. As different fad diets pop up, more people—including those in the health care space—are buying into their effectiveness.

But how do you identify which nutritional findings are evidence-based, non-biased studies? Hughes said anytime anyone hears of a claim based on a new research finding related to nutrition; they should immediately be skeptical. He said the first step is to identify who is conducting the study and if they’re doing it on anyone else’s behalf.

If someone presents new findings of a new diet based on celery and carrot juice, for example, and a celery farming conglomerate funds it, Hughes said that should raise red flags. We should also look at the patients who participated in the study, what other types of dietary restrictions they were put under, and what the credentials of those performing it are.

“We need to determine why the study was done,” Hughes said. “We should ask, ‘Is this evidence-based at all, and what are the limits of this?’ This is professional education at its root—becoming a better consumer.”

Hughes also said it’s important to understand our unconscious biases. It’s human nature to believe something that confirms what we already believe or what we want to be true.  That’s why we gravitate to “facts” that reinforce something good for your diet, like the myth that having dark chocolate or a glass of wine is good for your heart.

“You’re going to find clickbait that says, ‘If you only eat grapefruit, your fat is going to melt away,” he said. “The diet industry is a multi-billion dollar industry. If I came out with a book that said, ‘Eat the pages of this book, and you will lose weight,’ someone is going to try that.”

One of the easiest ways to combat any sort of eyebrow-raising study is simply to go to the primary source. Hughes said health care professionals should read studies on which claims are based. Reading through the methodology will reveal the findings, the players and any outside influences it might have.

Talking to Your Patients About Nutrition

For patients in cardiopulmonary rehabilitation, examining evidence isn’t always so easy. Many patients don’t know to look for who is funding a study or evaluate the claims being made in it. Hughes said it’s important to talk through these things with patients from the get-go to ensure they don’t fall victim to a fad diet they see on the internet. 

“One of the things we can do is try and clarify what exactly a study is saying,” he said. “Talk things through. Have them go out and get a newspaper clipping or ask if they’ve heard someone say if you have wheatgrass that will help shortness of breath. Ask why they believe that, look at what the evidence says and talk about diet holistically.”

For many, the word “diet” is a stressor. Talking through nutrition, what works and what can help patients be more compliant to their overall cardiopulmonary rehabilitation care is essential. Most importantly, health care professionals should help their patients look for key indicators that nutrition information is good.

“Our approach should be a non-judgmental and include some assessment,” Hughes said. “Not being judgmental, being realistic, and getting some information on what the patient does or believes is a good place to start. It should be hands-on and collaborative. Realistically, they’re not just going to do whatever you say based on one hour of interaction. The more you teach them to know how to evaluate nutrition claims for themselves, the better.”

Register for the webinar on AACVPR's website.