Where does the Truth “Lie”?
Have you ever found yourself trying to research information about a new product and you link to a web site that just doesn’t feel right? You are looking for a concise description of the product, including the ingredients, and it is just not there to be found. This happened to me recently, and I felt like the product must have something to “hide”. To me, the more you have to search through the various links of a site without gathering clearly stated information, the less reliable the web site.
Magazines and books can be just as misleading. Have you looked at the Health and Nutrition section of your favorite book store? Of course, there are trusted authors that we all have confidence in their writing with the backing of science-based information. Then, there are the writers whose books have hit the top of the best-seller list with the latest diet, but that certainly doesn’t make their writing credible.
Unfortunately, I imagine that consumers don’t question the reliability of web sites and print material as accurate resources for their health and nutrition information. For those of you in nutrition counseling, I am sure that you experience this on a regular basis – your client has read information on the Web or in a book and believes that because it is in print - it is accurate. To add to the confusion, now there are a multitude of blogs to cull through.
My failure to find the information I needed made me wonder how Registered Dietitians determine what is a trusted source and what is a questionable source for health and nutrition information. In my search to answer this question, I polled approximately 20 of our ArDA members, with eight responses, to find out their thoughts. Their much-appreciated responses are listed by whether the source is a trusted one or a questionable one.
These web sites are considered trusted sources of health and nutrition information by the members polled (* indicates that the source was listed by more than one RD): Medlineplus.gov and Healthfinders.gov “have links to other sites”, Cleveland Clinic, American Diabetes Association*, American Heart Association*, Centers for Disease Control (CDC)*, The Community Guide by CDC, United States Department of Agriculture (USDA)*, Center for Science in the Public Interest (CSPI)*, National Heart Lung and Blood Institute (NHLBI)*, Mayo Clinic*, Arkansas Dietetic Association (ArDA)*, ADA Knowledge Center, ADA Nutrition Care Manual, ADA Evidence Analysis Library, National Institutes of Health, Prevention Institute, The Community Tool Box, MyPyramid*, Robert Wood Johnson Foundation, Action for Healthy Kids, Alliance for a Healthier Generation, Food Allergy and Anaphylaxis Network, Bell Institute, National Dairy Council*, WebMD*, International Food Information Council Foundation (IFIC), RD411, PubMed, University of Pittsburg Medical Center patient education materials, CalorieKing, Dr. Andrew Weil “He can be kind of out there, but explanations of things often are easy to understand, and for the most part – I trust him.”, USDA Nutrient Data Laboratory “great place to find nutrient content of foods, can search by any serving size which is great.” and state cooperative extension web sites.
These print sources are considered trusted sources of health and nutrition information by the members polled (* indicates that the source was listed by more than one RD): Today’s Dietitian*, Diet and Nutrition (for consumers by Today’s Dietitian), Diabetes Educator, Diabetes Health (Professional Version), Journal of the American Dietetic Association*, ADA Times*, Nutrition Action Newsletter (CSPI), Health, Cooking Light “Health and Cooking Light use RDs for the background info which is reassuring”, Mosby’s Medical Dictionary, Understanding Nutrition, 11th edition Whitney and Rolfes (UCA Nutrition Textbook), The Health Professional’s Guide to Popular Dietary Supplements, 3rd edition Sarubin and Thomson, Journal of Clinical Nutrition, Journal of the American Medical Association, New England Journal of Medicine and Obesity Research.
These web sites and print sources are considered questionable sources of health and nutrition information by the members polled: Prevention Magazine “I think there is questionable information”, diet books or TV programs written by lay people, gym trainers, Nutrition Action Newsletter (CSPI) “read carefully - contains hype in my opinion” “Not sure I would say this is questionable since I do enjoy reading it – but I always assess content with a grain of salt! Having a decent background knowledge in nutrition lets me filter the information, unlike a consumer who might consider all content to be ‘gospel’.”, “most women’s magazines unless quoting from an RD – then still must read carefully”, “websites promoting sales of diets or diet products due to the for-profit aspect”, Wikipedia, WebMD, Prevention, “most web sites that don’t have .gov, .edu or .org.”, “I usually steer clear [of] very commercial internet sites” and “I have not found the ADA library helpful when I’ve tried to use it. It would seem that this should be the best source, but I haven’t found that to be so.”
When members were asked “Does the source of funding for a research article impact your belief in the article’s credibility?” these answers were given: “Funding is not as important as the source” “I feel that most research articles (although they may be pharmaceutical driven) are fairly reliable if published in a professional journal. These are normally peer reviewed.” “Absolutely. If the research outcome is favorable for a certain product, and the product’s company sponsored the research, then I discount its veracity.” “Yes, if you can determine the source of funding. You would expect a company to support research and publication of information that promotes their products.”, “If a large, well-known company or a government organization has funded the research, then I assume that proper methods were followed and the study is more ‘legit’.” and “Yes, if the research was funded by food industry the results may benefit that food industry and may not be trustworthy. I think that it depends on what the research is on, who is doing the research, and who is funding the research. I think if the research is evaluating a program then the evaluation should not be done by the same group that runs the program. So for example, ACHI/ADE/ADH oversees implementation of Act 1220/BMI but the COPH actually does the evaluation.”
RDs were asked to list web sites or other resources that they regularly recommend to clients/friends/family/students or parents for their consumer nutrition and health information. These were the responses: ADA, CDC, Smallstep.gov, CSPI, NHLBI, The Community Guide (CDC), Prevention Institute, The Community Tool Box, Weight Watchers, The Health Professional’s Guide to Popular Dietary Supplements, 3rd edition Sarubin and Thomson, Cooking Healthy Across America, ADA publication from the FCP DPG, Complete Food and Nutrition Guide, 3rd edition ADA, ADA “although a lot of the info is on the Member’s Only section that can’t be accessed by the consumer”, MyPyramid, Celiac Sprue Association, American Diabetes Association, 3ADay.org , WebMD, Cooking Light (web site and magazine) and Mayo Clinic.
Submitted by Celia Harkey, Midwest Dairy Council