Reader beware.

Long time readers of this site may know that I’ve had some pretty serious health problems in the past couple of years. Last year while undergoing emergency surgery for a horribly infected insect bite, I was diagnosed with pre-diabetes. And in August, I got the diagnosis that everyone dreads getting. Perhaps because of this, I’ve become extra sensitive about online information about health. The more I’ve read and researched, the more I’ve become aware that, while there is a lot of great information out there, there’s also a lot of iffy crap being disseminated. And you know, bloggers are amongst the worst offenders of this. I include some of my fellow food bloggers.

I see blogs out there who blithely tell people how to self-diagnose themselves, and even self medicate, for serious illnesses. I see nutritional advice that may or may not apply to anyone othe than the writer. I see more than few instances of pandering to hypochondria, intentional or not. I also see the unquestioned acceptance of, and dissemination of, wrong or dubious medical, health and nutritional information. And it’s just not right.

A while back there was a movement to get food bloggers to sign up to a uniform code of ethics. While it addressed things like disclosing whether a restaurant meal or a product mentioned on the blog was paid for by a third party or not, it didn’t say anything about the need for at the minimum, attaching disclaimers to any information with potentially harmful effects, or stating the qualifications of the person espousing that information.

This is not just limited to blogs run by individuals either. I ran into an issue with a ‘big’ health blog some years ago, which decided to twist my words and spout out some laughably wrongheaded information. I still look back on that incident with disbelief. Sheer common sense would seem to indicate that ingesting lumps of highly refined carbohydrates, including tons of sugar, is not conducive to any kind of weight loss. But there it is. (I see that the original post is not reachable anymore, though it stayed up for a long time after it was posted. (Update: you can read it in the Internet Archives.)

Soon after my pre-diabetes diagnosis, I did think about including more diabetes information on these pages. But after a while I found myself unable to do so with good conscience - because the information out there can be confusing and contradictory. The diabetes eating movement seems to have somehow gotten all tangled up with ‘low glycemic index’ eating, ‘low-sugar’ eating, ‘low-carb’ eating, and even ‘gluten free’ eating . They are not the same, but people get them all mixed up.

For what it’s worth, I do think that low glycemic index eating (which emcompasses low-sugar and to some extent, low-carb eating) may be beneficial to diabetics, but that is just my layperson’s opinion. It’s worked fairly well for me, in conjunction with medication (I’m not on insulin), but that’s just one case.

That is always important to remember when reading about eating guidelines online, whether they apply to diabetes or any other illness or medical condition. (Food allergies are an especially murky area.) Most of the time it’s a layperson’s opinion. That layperson may or may not have done adequate research, and asked a lot of questions. That layperson may have some preconceptions and prejudices that you are not aware of. And what works for that person may not necessarily apply to you.

I know that, especially in the United States, there is a general feeling of mistrust against the medical establishment, “Big Pharma” and the establishment in general. In addition, a lot of people unfortunately have inadequate health insurance, so they must turn to sources other than their family doctor (do family doctors even exist anymore in America?) or other medical professional they can meet with face to face. So they turn to the internet. This can be a dangerous thing, unless you go about it in an analytical way. The bottom line is: Check many sources and keep an open mind. In terms of trust, I would place more in information from long established organizations before that of a individual blogger, however wonderful his or her writing may be. Least trusthworthy of all may be information presented by organizations with some sort of axe to grind. (There are several of those in the soy controversy area for example.) But in any case, take your time and check many different sources. I am a born skeptic and cynic myself, and I always think that it’s a good thing to gather information with a skeptical frame of mind.

Since I’m exposed to medical and health information from three distinctly different cultures and countries - the U.S. (and the UK…these two share a lot, besides the language, though there are differences), France and Japan, I see a lot of discrepancies as to what is considered good or bad for you. For instance, in France the belief in massage with special creams and massagers to get rid of cellulite still holds sway, although that’s been largely debunked in the U.S. In the U.S. green tea is supposed to be so healthy for you that you can get it in all kinds of format, including with loads of sugar or HFCS added to it. You can even get green tea extract in stuff like moisturizers, for crying out loud. In Japan, green tea is an everyday, common beverage, so instead the amazing weight loss and other benefits of exotic teas such as mulberry leaf tea or various Chinese teas are touted. So what’s going on here? It’s up to you to go out and find out more, rather than swallow something without question just because ‘everyone’ says it’s ‘so good for you’.

Some health and eating information seems to be universal. Fresh vegetables are good for you, as are fresh fruit in moderation. Eat a balanced, varied diet. Watch your sugar and fat intake, especially the saturated kind. Whole grain products are generally better for you than refined grain products. Get some exercise. Don’t stress out too much. Most things above and beyond that seem to be up to debate. (In my layperson’s opinion, moderation and real food are keys too. It’s fine to drink brewed green tea, but taking concentrated green tea supplements is unexplored territory. Eating tofu for dinner? Great! Taking massive doses of soy isolates? Not so much.)

In any case, if you do see a food blogger (I’m not naming names, since I am not here to call out specific bloggers) who tells you that his or her way to eat is the only true way, you may want to back off a bit. Even if that blogger is me - especially if that blogger is me. (If I start writing stuff like that, you can be sure that I’ve lost the plot.) Determining whether a food blogger is a good cook or not is easy; just try out a couple of their recipes, and see if they work as advertised. Determining whether the information they spread is good or not is a bit more tricky and requires some work on your side.

And if you are a fellow food blogger reading this, and you haven’t already clicked away, please dispense of your sage advice with caution and care. As an individual blogger, I really feel it’s so important to self-edit ourselves. Like it or not, total strangers listen to our advice. It’s a sobering thought.

Further reading

When it comes to covering medical and science issues, mainstream media can be one of the worst culprits in spreading half-baked or even erroneous information. If you’re interested in a skeptical look at journalistic coverage of these topics, the Bad Science blog is a great place to start.

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28 comments so far...

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Re: Reader beware.

I totally agree with your post. Nowadays, several unqualified bloggers claim to unfold the truth about "the perfect way to eat stuff [when you have diabetes]".

I used to study life science some years ago and what I sure learnt is that there's no way a specific diet can apply to more than one person.

Definitely, the reader should beware and should read (and I mean, in scientific publication/encyclopediae) about specific therapies/diet BEFORE getting into them, so one can fully understand why this diet is good/bad on his own instead of just following some... disgusting fashion health diet which will be proven wrong years after.

Tamok | 2 November, 2011 - 18:37

Re: Reader beware.

Good post. I agree that people should be extremely careful about health information on the web.

However, I think it's important to note that the last word should *always* talk to their a doctor about their health issues.

And if your doctor isn't comfortable talking to you about your specific health problem, get them to refer you to one who is.

Will | 2 November, 2011 - 19:06

Re: Reader beware.

Yeah, I share a lot of my diabetic experiences because I don't want people to feel like they are alone in the world. The important thing for newly diagnosed diabetics in my opinion is to let them know that they are not alone.

Just knowing that should help a lot of people I think. Just relaying my experiences I hope deters people from just blowing it off and not doing their tests and stuff. The results can often be devastating. At least in my case they were.

But yes, there are many sites out there that tell you what you should be eating. I consider those guidelines. I don't take them all to heart. I simply tell everyone that only a doctor can diagnose your illnesses, and only a nutritionist can tell you what you should eat because they both have studied YOU and can prescribe something suited only for YOU.

Not everyone is the same. And when people realize that Dr. Google is not the true answer, the better things will be.

yoshi | 2 November, 2011 - 19:07

Re: Reader beware.

The thing that makes me the most sad about this is that apparently diabetes dietes are now "the thing to do" even if you don't have it, because "no sugar= no fat!" on some places i've read. (Which i find a bit ridiculous). It's makes it dangerous for one that really have diabetes to go and read without taking a doctor advice in first consideration. I am lucky to live in Canada for that, with our healthcare i have my family doctor and i could even have access to a dietist if i finally get diabetes.

I tend to find the blogs where they go: my diet way, or no way, are trying in the end of selling us something. Funny, because most of them usually have a book and some "health sponsors" by which they swear.

Open mind and cristicism are good friends indeed.

(sorry for the typos, eng. aint my main languague.)

Vinie | 2 November, 2011 - 19:33

Re: Reader beware.

Yep, just got diagnosed with high cholesterol and mild anemia. When I talk to my friends about it they all try to give me advice, to which I politely digress "Ya know, I'm just going to do what my doctor told me to do and see how things go." I appreciate the good intentions for sure, but my doctor (and he is a family doctor, they do exist!) is the only one truly qualified to give me advice I need.

anon. | 2 November, 2011 - 19:43

Re: Reader beware.

I'd say a doctor is a good place to start but a true specialist would be the best and in the US (sorry don't know where you are from)would be a registered dietican. A doctor spends a few hours to maybe a semester on nutrition depending on the medical program and a RD spends four to five years on nutrition, depending on the program.

anon. | 9 November, 2011 - 22:44

Re: Reader beware.

It takes a team! I absolutely agree that a dietican or a nutritionist would be able to give better nutritional advice than any doctor, but seek medical advice from your MD... Too bad most of the Doctors I know aren't team players!

goodybrook | 8 January, 2012 - 08:11

Re: Reader beware.

I am sorry about your situation. I am glad that they caught it when it was early. My mother went through the same thing when she was 25, and I saw what it did with her.
As for diabetes, the subject of diet is a very, very sticky issue. As for trusting the establishment - well, I have the mind of a skeptic too. So much so, that I have ALWAYS questioned authority, let alone anything told to me.
The problem today is that when it comes to diabetes, the establishment has a one-size-fits-all approach. Eat the way you like, and medicate to cover your insulin dysregulation. This was fine before the internet age, when people actually began to compare notes.
Suddenly, you start to see that there is blatant conflict of interest by the establishment, and the authorities that are trying to "help" your condition. That's where it really begins to get tasty!
I have always said, follow the money. What I can tell you is that I disregarded the information I was given (I was misdiagnosed in the beginning as a T2 diabetic, when I am actually a T1 - and need insulin!) I did the opposite, and managed to get my numbers down, cholesterol down, and basically get everything down to a non-diabetic level. (With insulin of course.)
I tried my hardest to beat the drum as a D advocate, using my blog to decry the establishment. Then I realized that it was futile. By railing against big pharma, and agriculture, I was just looking like a stark, raving lunatic.
Instead, I focus on what I do know - and that is how to cook, as a professional. If someone asks me about my diet plan, I will gladly tell them. Not proselytizing mind you, just explain. I find that most people try and tell me how to eat. I know what works for me, and that is what I suggest to most people now. N=1, and no one-size-fits-all approach. I hoe that with time, people will just follow me, because it just makes sense.
Ghandi said, "Be the change you are trying to create." That is how a food blogger should roll, in my books. I trust someone who can show what they are doing more than the one crying off the mountain tops. At least I know they are legit.

Jason Sandeman | 2 November, 2011 - 20:09

Re: Reader beware.

I hope I don't make the water even muddier with this comment but I'd suggest people be wary of anyone calling themselves a nutritionist.

anyone can claim they're a nutritionist as the title isn't a protected one in the way a doctor or nurse is. In the UK the term "dietician" is protected and to name yourself as such you have to have the right qualifications and belong to an appropriate professional body. I'm not sure the same goes for the US - what is for definite is that in both the US and UK nutritionists are a mixed bag. There are some decent, honest people who know what they're talking about who are trading as nutritionists but also a large number of quacks trying to sell products and miracle cures to the desperate and concerned.

as maki mentions, the bad science blog is a good place to start if you want to get some sound advice on the nature of health claims related to food - and it's an entertaining read as well

Don Gately | 2 November, 2011 - 21:34

Re: Reader beware.

It's the same in the US; to call yourself a dietitian (or registered dietitian) you need to meet set educational requirements, complete an internship, and pass an exam.

anon. | 8 November, 2011 - 19:26

Re: Reader beware.

i think it's great that there are blogs that are focused on such experiences/diets/medical conditions, and while it's a great way to reach out to others going through similar experiences, it's both up to the reader and blogger to know that it's just that. Similar, but not THE SAME.

great post!

suki d | 2 November, 2011 - 22:06

Re: Reader beware.

Re: Finding good health information online
This is so true. I am a teaching and reference librarian. It is amazing to me what students will find and cite as reliable. I try to teach them to watch out for personal pages, dot-coms and even some dot-orgs when it comes to health information. Start with http://health.nih.gov/ for great consumer health info (no ads, nothing kooky; also http://www.nhs.uk/). The National Institutes of Health pages are great by themselves, but if you find a reference to a research study or article, your library can usually get it for you for a nominal charge. Most public libraries nowadays also provide access to at least one keyword-searchable medical/health/nursing database of real research studies.

Denise | 3 November, 2011 - 05:31

Re: Reader beware.

I'm so happy you posted this Maki!! There are just so many gullible people who have no sense of critical thinking! I will always place my trust in a doctor who had years of training and experience than a self proclaimed nutritionist on a blog...I mean really, your just buying into some questionable authority otherwise.

anon. | 3 November, 2011 - 05:47

The Milk and Calcium Conspiracy

I couldn't agree more! As a marketing professional, I have to admit that I am sometimes one of those people guilty of manipulating what consumers think are good or bad for their health. I don't like it, but that's what the clients want and that's my job :(

My mother-in-law is one of those people who believes in everything that is published - a blog, a magazine, a forwarded article in her email. She is a very weak and unhealthy person for someone who is only 54 and I am very worried about her taking all the misleading advice from unreliable sources. For example, she only drinks from disposable plastic cups and throws away hundreds of those cups each month because she read somewhere that reusable ceramic or glass mugs and cups have bacteria in them (true IF you don't wash them properly). I am very concerned about BPA or other chemicals in those $2 for 100 plastic cups but she wouldn't listen to me because my advice is not published.
As a lactose intolerant person, I once believed that I MUST take calcium and magnesium pills to make up for my inability to digests dairies. It's amazing how the dairy industry established such a strong image that milk products are the only main sources of calcium. Just because we don't usually see broccoli, almond, avocado and carrots being branded and advertised like milk, yogurt and cheese doesn't mean that they are not good sources of calcium. Avocado on toast in the morning, steamed broccoli and carrots for lunch and some almonds for snack during the day and I'm pretty sure I'm absorbing more calcium from these vegetables than people who just drink milk :)

Tracy | 3 November, 2011 - 06:13

Re: The Milk and Calcium Conspiracy

if it helps, the plastic cups are probably covered in bacteria too, everything on earth is covered in bacteria unless it's specifically treated to kill them, and then isolated (think autoclaved dental instruments in a sealed package) there are more bacteria on and in the human body than there are human cells. unless she's rubbing raw chicken on her coffee mugs after they're washed, her coffee cups don't have anything dangerous on them. she's just wasting money and creating a LOT of trash.

On the other hand BPA is only present in some types of plastic (only in some of types 3 and 7) and it's dangers are still under investigation, but mostly of concern in pregnant women and small children, so there's probably not too much to worry about there either.

Myxini | 5 November, 2011 - 07:15

Re: The Milk and Calcium Conspiracy

I did look into the BPA situation some time ago, when it was the 'big' health concern of the day and people were asking about BPA use in plastic bento boxes. Apparently BPA is most used as liners in cans these days, as well as transparent disposable plastic containers. (They used to be used in baby bottles, but that's virtually stopped now.) Anyway, if it makes you feel better perhaps you can persuade your mother to at least use non-transparent cups... though I agree her avoidance of ceramic cups is a bit...extreme. I guess it will not help to make her aware of the can-lining thing....

I sort of stopped drinking milk some years ago except occasionally. We don't have a carton of milk as a matter of course in the fridge anymore, since neither of us is that big on cereals. But I eat almonds and other nuts all the time, as well as green vegetables. And of course, cheese!

maki | 5 November, 2011 - 11:52

Re: Reader beware.

Thank you for this post! I have had a similar view of many sites that claim to be diabetic friendly, or gurus on diabetic health, but many things they state are deceiving, or an outright lie.

There is also alot of old information out there on the web that people have not let go of yet, and even though that old information might be life threatening, they insist on spewing it forth like it came from the Bible!

As the caregiver (of 12 years) for a husband who is diabetic, a mother and sister who are diabetic, I can tell you one thing that is for sure: if you don't properly educate yourself on your own specific health problems, then you will never BE healthier. No matter how many times the doctor tells you that you need to lower your blood glucose levels, unless you're ready to do the work, it won't mean squat.

Another good read, thank you again!

MsSooz | 3 November, 2011 - 07:26

Re: Reader beware.

There is an Arabic saying that means, "The man who lives far away, has the most effective secret".

Ok, translation sounds odd, but basically means that we are quick to believe foreign things work better, then our local ones. Egypt has a notorious market for 'Asian' diet, impotency, porcelain skin you name it teas. And people buy them by the bucket-load.

My cousin swore by Dr Mings Original Chinese Weightloss Tea (which cost her about 25$ a box, insanely expensive for Egypt), because she lost like 50 lbs. BUT did I mention the directions were to drink 5 cups a day, and limit your food intake. Turned out to be a very expensive laxative, but she still swears by it!

In the end of the day, I think people are responsible to use their brain and be wary. If you are looking for a quick fix, more times than none, it doesn't exist.

And Maki thanks for straight out saying it!

Ameirah | 3 November, 2011 - 09:13

Re: Reader beware.

Thanks for posting this. I must say it is great to have a food blogger who does tell you that most of what's on the internet is utter rubbish. I'm a huge partisan of cooking as much from fresh as possible and I can't abide by the low-fat stuff. Then again, that's just me. Still, some of the stuff I've heard over the years about everything is quite simply mind-boggling, so again, it is very nice to have someone reminding us of just how much nonsense is out there.

Anne | 3 November, 2011 - 10:07

Re: Reader beware.

THANK YOU!!! I have had a similar opinion for a very long time. And recently, I have been seeing more and more 'layman doctoring' and self-doctoring. I belong to a couple 'support' groups on facebook for one of the medical conditions I suffer from. I can not believe the number of folks who post asking for medical advise that they should be asking their doctor about AND the number of folks who give their opinions as law.

teresa g | 3 November, 2011 - 14:51

Re: Reader beware.

There was a recent extract from a book by Daniel Kahneman in the Guardian about cognitive illusions which helps explain why so many people are so cocksure in their assumptions and 'skills' regarding health and diet
http://www.guardian.co.uk/science/2011/oct/30/daniel-kahneman-cognitive-...

Loretta | 3 November, 2011 - 20:46

Re: Reader beware.

My sources of information on anything alt-med related are
Science Based Medicine and and The Quackcast (I tried to leave links, but it triggered the spam filter) both are run by physicians and actually look at the data and explain how and why it (usually) doesn't work. Or if there is some evidence that something works, will give REAL information about how it might work, and what the limits would be. basically if some crazy thing is being touted as the Big Thing That Cures Everything, they'll cover it. '

example: yogurt marketed to fix your digestion is the same as any live-culture yogurt. superfruit juices (while sometimes tasty) have much lower levels of antioxidants than an ordinary apple. 'Boosting the immune system' is marketing-speak with no science behind it (activating the immune system = inflammation, not something you want as an everyday state)

as a scientist-in-training, it always makes me so sad when people throw money and effort at things that will do them no good, especially when they use alt-med instead of real medicine... like Airborne (an expensive, potentially dangerous vitamin at best) instead of flu vaccines. alt-med is just selling snake oil to desperate or confused people :<

Myxini | 4 November, 2011 - 21:36

Re: Reader beware.

Great article. The Internet can be a great source of info, when used correctly. When it came to controlling my type 2 diabeties a system I learned from an Austrialian has been the best. If you have a blood sugar meter you first find when you find when your blood sugar peaks after eating. I checked my blood after eating ever 15 min for 2 hours after eating. After collecting enough data to have confidece in when to test. Next I test what foods did what to me. My A1Cs are now in the low 5s because I have an individual meal plan. One thing to keep in mind with all medical advice - it starts general and if that works on you great. My body tends to have the oppisite of expected effects.

Mark Hogan | 5 November, 2011 - 18:35

はじめまして ;)

こんにちは、マカロンの作り方を検索していて"アーモンドプードル"を調べていたときにこちらのブログに出会いました。
私は先月10月に東京からドイツに引っ越してきた22歳の学生です。越して来て一ヶ月経った今、日本食が恋しくなってしまって大変で、先ほど父が送ってくれたコシヒカリ(魚沼出身なんです)を食べて泣きました笑 こんな甘くておいしいお米の味がわかるあたしたち日本人てすごい、日本人でよかった、ってみそ汁もいただきながら今更ながら実感しました。みんな、ライスには味が無い、日本の米はstickyで食べずらいなんて言うけど、噛んで出て来る深い甘さやうまみがわかんないかな〜って思いますね。こうしてイトウさんが日本食を海外の地で広めていらっしゃるのを見てすごくすごく誇りに感じます。私も今自分が作る料理やお菓子,日本食(もどき)のレシピなんかも載せようかな、と思いました。Postと関係のないコメントになってしまいましたが、イトウさんのブログに出会えてよかったです。I'll check here out often for updates <3

Meg

Megumi Nagumo | 13 November, 2011 - 20:33

Re: はじめまして ;)

めぐみさん、はじめまして ^_^

ブログを読んで頂いて光栄です。

本当に、日本のお米は美味しいですよねー その美味しさが解らない人が可哀想に思ったりします。

ドイツでの留学生活、色々と大変な事もあると思いますが、がんばって下さいね。フランスから、応援します!

maki | 13 November, 2011 - 22:47
EKenzie | 15 November, 2011 - 21:32

Re: Reader beware.

Hey!

That's an issue that comes up for variety of different topics ... and it makes me sad. There are trusted sources for people to go to (.gov, .edu, and trusted medical sources as well as peer-reviewed studies you can find on Google Scholar) but I'm not sure why it seems to be difficult.

There are small groups of people here in the US who are against getting vaccinated. They opt for treatments that have no basis and solely on layman's opinion, instead of listening to the health professionals.

It's frustrating because there are people like that for every health topic.

Cynthia | 16 November, 2011 - 02:31

Re: Reader beware.

Don't be so impressed with the experts and don't be so dismissive of lay people.

Registered dietitians are now being given formal education by the Coca-Cola Company on how safe its ingredients are. How impressive is that? I've also seen patients walk in with encyclopedic knowledge of their condition, swamping any doctor in the room. Just because a person doesn't have a piece of paper doesn't mean they don't know what they are talking about.

I'm a Chiropractor which means I got the same human physiology, biochemistry and nutrition training as a medical doctor. It's good, factual and not 100% accurate. Two of the things they do, and it's in the textbooks also, is they conveniently forget to discuss what happens with the krebs cycle once carbohydrates are not easily available. You get a half story, not the full one. The other thing they do is blur the line between ketosis and ketoacidosis, making them look like one and the same. The advice you get, the food pyramid or it's derivatives, are great for fattening cattle but not so good for keeping people healthy. Anyone familiar with feedlots knows that the cattle eating like we are told have to be on constant antibiotics and other drugs to keep them alive before being slaughtered. We get treated pretty much the same in my opinion, we just have bigger bank accounts.

Quote:

I do think that low glycemic index eating (which emcompasses low-sugar and to some extent, low-carb eating) may be beneficial to diabetics,

Carbohydrate, sugar, starch are all the same thing, just different words. Is it a street, avenue or lane? Same thing. Street name changes, still the same road.

Diabetes is a disease of insulin and sugar metabolism. Quit putting in the sugar and there is less need for the insulin, there is no maybe about it. High carbohydrate intake as suggested by the AMA approved food pyramid is great for raising insulin levels and keeping them there which in turn leads to the major killers of today. Good for them, good for the pharmacy companies not so good for people. With the "obesity epidemic" I think we can see that people really don't need all that energy, which is all carbs give to us, so backing off on them is a great idea. There are no essential carbohydrates like there are amino acids and fats. Fat does have more energy per unit of volume BUT it doesn't raise insulin so doesn't put triglycerides into adipose cells which is what makes us "fat".

One last note, if your diabetes does progress and you become insulin dependent, there is a bariatric operation called a Vertical Sleeve Gastrectomy which has in some cases reversed the diabetic condition. No, it doesn't regenerate the insulin producing cells but people that have had it have been able to go off their supplemental insulin in many cases.

Good luck, the very best to everyone.

Gary Green | 3 December, 2011 - 10:49

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