Part of the difficulty in determining what advice to take for your health, for example, regarding lifestyle or foods to eat, is that journalists and consequently the media, have a very poor understanding of how science works. Articles are written recommending that you take this, or don’t do that, based on the most recent “breakthrough” which has been published. The following month another article is produced, recommending that you do the exact opposite! In science, there are very seldom “breakthroughs”. This is not how knowledge is usually acquired. Scientific articles are published concerning particular observations, these articles then have to be validated and the work they report reproduced and then fully evaluated in the context of current knowledge. Often, it can take many, many years before the “truth” or otherwise of a finding, is verified. A good way of thinking about how science works is to imagine that our knowledge of truth lies hidden behind a large brick wall. All the biggest breakthroughs manage to achieve, is to loosen a very small brick in the wall. After many more years of work, even if the brick is eventually dislodged, we still have a very limited view of what lies behind the wall. In this light, it is prudent not to pay too much attention to the “latest finding”. Wait for the fullness of time, which allows the information to be properly evaluated and assimilated.
A recent development which originated across the Atlantic and unfortunately has found its way into health promotion, is the rise of a “celebrity” culture. Coupled with this is a tendency to denigrate learning and reflection and there are new “experts”, whose only expertise is in how to be famous and have the spotlight continually focused on themselves. They are usually opinionated and sometimes coarse and loud. They often give advice based on their own or their spouses (usually several) experiences, as if these experiences applied to everybody and were established scientific fact. In this new world, image and appearance have replaced substance. If you are flying in an aircraft, which do you prefer, a properly trained pilot or a pilot trained in two weeks (or less), with a degree from the previously unheard of School of Homeopathic Flying?
Of course, having qualifications is no guarantee that you can talk sense (or won’t crash the plane) but at least it is a start and the higher the qualification, the better the chance that you will be knowledgeable about your topic. Any qualification however, is simply an endorsement that you have completed an area of study, in which you have been exposed to the accumulated human knowledge on that particular topic. In health related areas, three to four years would generally be regarded as the bare minimum period of study. Higher degrees for example, MSc or PhD degrees, are additional study periods and an endorsement that you may have learned how to learn, or to put it slightly differently, how to properly acquire and evaluate knowledge in your area.
This brings us to the nature of knowledge and the oft used quote from Socrates that “The only true wisdom is in knowing that you know nothing”. For this reason beware of dogma, certainty and rigidness of approach. Beware especially, of those that feel there is no limit to their own level of knowledge. Being open to, and admitting weakness, is after all a reflection of strength. If one is looking for advice, it is always reassuring, if the person you are seeking advice from, is open to the limitations of their own knowledge.
Be careful also of this mythical concept of scientific proof. There is no such thing as absolute proof. Science always works within the realm of probability. Science and medicine use the principle of evidence based decision making. Such evidence is never absolute, but when used correctly, this approach has been spectacularly successful. In health terms, this has resulted for example, in the complete elimination of small pox and the transformation of our ability to deal with many of what were once fatal conditions. It takes many years of training to be able to determine the quality of evidence and to use it appropriately in decision making. Unfortunately, there is simply no short cut possible here. In this context, can you make appropriate health decisions based on a thirty minute surf through the internet?
On the subject of the internet where are the appropriate and reliable sources of information to be found? Websites attached to major universities are usually validated and a good source of information. Government based websites such as the NIH website (U.S. National Institute of Health [www.nih.gov]), NHS choices National Health Service UK [www.nhs.uk] HSE (Health Service Executive [www.hse.ie]) are all treasure troves of useful and accredited information and links. Various professional bodies and Expert Groups associated with health care also issue useful reports and recommendations e.g. The Nutrition Society UK (www.nutritionsociety.org) or the American Society for Nutrition (www.nutrition.org). Beyond these types of web-sites, be very cautious.
Extreme caution is also the byword when evaluating information in any way associated with commercial sources. In general in science, evidence has to be completely untainted by commercial interests before it can be given credence. In the health care area this generally (but not always) means the pharmaceutical industry. The most common way you are likely to experience this, is in the whole area of supplements marketed to promote health or tests to diagnose allergy. Bear in mind that this area is very poorly regulated and all sorts of spurious claims and suggestions can and are made. Some of these claims are quite subtle and clever. For example, last winter there was a large supermarket promotion of a certain product, under the banner “Is your immune system winter ready?” , followed by the name of the product. Now the manufacturer did not claim that their product could make your immune system winter ready but the suggestion was strongly made. Are there any food supplements that can make your immune system winter ready? Based on our current understanding and if you are eating a healthy diet, the answer is almost certainly no, but more of this anon.
Finally, be aware that science, like other things often moves with trends or fashions. In the whole area of health science, the current fashion that has been raging for some time now, is the impact that our genes have on health and disease. Looking at it from the outside you might think that everything was dependant on our genes. In a certain sense this is true. However, this whole field is moving into the area of how our environment (and actions) may influence the expression of our genes. It will be many years hence before we have a more comprehensive understanding of where all of this lies and we learn to manipulate this understanding for greater good. However, we also know that all diseases have many causes and there are always a variety of factors which impact on them. This must surely be an optimistic message, as it implies that there are many things in relationship to our health that we have control over. But I guess you already knew that didn’t you?