Nutrition
BEWARE of claims that have a bad basis
Many claims about the effects of treatments are not trustworthy. Often this is because the reason (the basis) for the claim is not trustworthy. You should be careful when you hear claims that are:
• Too good to be true
• Based on faulty logic
• Based on trust alone
People often think about the benefits of nutrition interventions and ignore possible harms. But nutrition interventions are not always 100% safe.
Most claims that nutrition interventions will make you 100% better, or that they work for everyone, turn out to be wrong.
We can rarely, if ever, be 100% certain about the effects of nutrition interventions.
‘Natural’ nutrition interventions are not necessarily better or ‘natural’.
We can rarely rely on nutrition interventions alone to completely reverse or cure diseases or injuries.
People who are sick often get better without an intervention. Sometimes a nutrition intervention will not help and may even make things worse.
Nutrition interventions that should work in theory often do not work in practice.
Just because using a nutrition intervention is associated with people getting better or worse, doesn’t mean that it was the nutrition intervention that made them better or worse.
More data is not necessarily better data, whatever the source.
Unless a nutrition intervention is compared to something else, it is not possible to know what would happen without it.
If a study of a single comparison of nutrition interventions shows that people who got one intervention did better or worse than people who got something else, it does not mean that is the final answer.
Just because a nutrition intervention has been used for a long time, or by many people, it does not mean that it helps or that it is safe.
Just because a nutrition intervention is new, expensive, technologically impressive, or brand-named does not mean that it is better or safer than other nutrition interventions.
Taking more of a nutrition intervention may increase harms without increasing how much it helps.
Earlier detection of ‘disease’ is not necessarily better.
It is rarely possible to know in advance who will benefit, who will not, and who will be harmed by using a nutrition intervention.
Someone with an interest in getting people to use a nutrition intervention, such as making money, may overstate benefits and ignore possible harmful effects.
If someone got better after using a nutrition intervention it does not necessarily mean that it was the intervention that made them better.
Just because a claim about a nutrition intervention is made by an expert or authority, you cannot be sure that it is trustworthy.
“Peer-reviewed” and published studies may not be fair comparisons.
International standards and laws about health and content claims for nutrition interventions exist, but are inconsistently implemented and monitored across countries.
THINK 'FAIR' – and check the evidence from treatment comparisons
Evidence from comparisons of treatments can fool you. You should think carefully about the evidence that is used to support claims about the effects of treatments. Look out for:
• Unfair comparisons of treatments
• Uncareful summaries of comparisons
• How treatment effects are described
Look out for comparisons of nutrition interventions where the comparison groups were not alike.
Look out for comparisons of nutrition interventions between studies that are different.
Look out for comparisons of nutrition interventions where the people in different comparison groups were cared for differently.
Look out for comparisons of nutrition interventions where people knew which intervention they received, and knowing this could have changed how they felt or behaved.
Look out for comparisons of nutrition interventions where what happened was measured differently in the comparison groups.
Look out for outcomes in comparisons of nutrition interventions that were not assessed in a reliable way.
Look out for comparisons of nutrition interventions where what happened was not measured in most or all people in the study.
Look out for comparisons of nutrition interventions where people’s outcomes were not counted in the group to which they were allocated.
Look out for summaries of studies comparing nutrition interventions that were not done systematically.
Look out for unpublished results of fair comparisons of nutrition interventions.
Look out for comparisons of nutrition interventions that are sensitive to assumptions that are made.
Look out for nutrition intervention effects that are described just using words.
Look out for nutrition intervention effects that are described as relative effects.
Look out for nutrition intervention effects that are described as average differences.
Look out for effects of nutrition interventions that are based on small studies with few people.
Look out for results that are reported for a selected group of people within a study or systematic review.
Look out for results that are reported using p-values instead of confidence intervals.
Look out for results that are reported as “statistically significant” or “not statistically significant”.
Look out for a “lack of evidence” being described as evidence of “no difference”.
TAKE CARE – and make good choices
Good treatment choices depend on thinking carefully about what to do. Think carefully about:
• What your problem is and what your options are
• Whether the evidence is relevant to your problem and options
• Whether the advantages are better than the disadvantages
Always ask yourself whether the outcomes related to a nutrition intervention that are important to you, have been measured in fair comparisons.
Always ask yourself if the comparisons of nutrition interventions included only people (or animals) that are very different from you.
Always ask yourself if the nutrition interventions evaluated in fair comparisons of interventions are relevant.
Always ask yourself if fair comparisons of interventions were conducted in circumstances that are relevant.
Always ask yourself whether the possible advantages of a nutrition intervention outweigh its disadvantages.
Always ask yourself how sure you are that the possible advantages of a nutrition intervention are better than the possible disadvantages thereof.