Evaluating Nutrition Information

1. Evaluating Nutrition Information Presented by Janice Hermann, PhD, RD/LD OCES Adult and Older Adult Nutrition Specialist

2. Evaluating Nutrition Information • Consumers are faced with an overwhelming amount of nutrition information. • Difficult to distinguish valid information from misinformation. • Nutrition misinformation can fuel food faddism, health fraud or misdirected claims.

3. Food Faddism • Unreasonable or exaggerated beliefs that foods or supplements may cure disease, have special health benefits, or promote weight loss. • Any people promoting food fads may also be victims of misinformation.

4. Health Fraud • Similar to food faddism, except it is deliberate and done for financial gain. • Promotion of a product to improve health, well-being or appearance for financial gain that doesn’t work or hasn’t been proved to work.

5. Misdirected Claims • Claims that cause consumers to make incorrect conclusions about the health benefits of food. • Claims mislead consumers to believe foods are more healthful than they are.

6. Contributing Factors • Shift in nutrition research from preventing deficiencies to preventing diseases. • Consumers taking an increased role in their health care and actively seeking food and nutrition information. • Often looking for simple, convenient, low-cost solutions. • Encourage opportunities for nutrition misinformation leaving consumers vulnerable.

7. Contributing Factors • In crease in older population. • Up to 60% of victims are older adults. • Increasing illness and desperation. • Increase is overweight.

8. Contributing Factors • Placebo effect • 25 to 30% respond to a placebo. • Promoters sue to intimidate. • Differences in laws regulating supplements and drugs.

9. Dietary Supplement Labeling • The Dietary Supplement Health and Education Act (DSHEA) set up the frame work for FDA regulation of dietary supplements. • FDA’s pre-market review of dietary supplements is less than that for foods or drugs.

10. What Is A Dietary Supplement • DSHEA broadened the definition of supplements to any product intended for ingestion as a supplement to the diet. • Vitamins & Minerals • Protein & Amino Acids • Herbs & Botanicals • Other Plant-Derived Substances • Metabolites, constituents and extracts

11. Dietary Supplements Are Not • Dietary supplements are not drugs. • A drug is an article that is intended to diagnose, cure, mitigate, treat, or prevent diseases. • Drugs must undergo clinical studies to determine their effectiveness, safety and possible interactions. • FDA approve drugs before they are marketed.

12. Monitoring For Safety • Food ingredients and drugs undergo strict pre-market safety testing and approval. • Dietary supplements to not have to go through FDA pre-market approval. • Once on the market FDA has to show a supplement is unsafe before it can take action to restrict it if a problem occurs.

13. Understanding Claims • Under DSHEA dietary supplements are allowed to use three types of claims. • Nutrient-content claims • Disease claims • Nutrition support claims • Structure-function claims

14. Structure-Function Claims • Manufacturers can use structure-function claims without FDA approval. • Structure-function claims must be accompanied with the disclaimer “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”

15. Consequences of Nutrition Misinformation • Delay or failure to seek proper health care. • Interference with sound nutrition education and practices. • Undesirable drug-nutrient interactions. • Toxic components in products. • Financial loss • Loss of trust

16. Sources of Information • Media leading source of nutrition information • Magazines (47%) • Television (34%) • Books (29%) • Newspapers (28%) • Doctors (31%) • Internet (21%) • Product labels (19%) • Families and Friends (18%) • Dietitians (13%)

17. Misinterpretation of Scientific Studies • Media often exploits preliminary research findings to increase readership. • Research findings are often turned into sales pitches and products before enough evidence is available to make recommendations to the general public.

18. Misinterpretation of Scientific Studies • Media reports rarely provide enough information for consumers to adequately interpret the advise given • Often fail to report details about how much more or less of a food to eat, how often to eat a food, and to whom the advise applies are omitted.

19. Misinterpretation of Scientific Studies • Four common types of inaccuracy in media reports • Reporting a correlation as causation • Generalizing a study’s results to a broader population • Exaggerating size of the effect • Using a single link in a chain of events to make predictions

20. Internet Sources of Misinformation • Internet is becoming a major source of nutrition information. • Accuracy of information on the Internet is not governed by any regulatory agency. • E-mail results in rapid widespread dissemination of misinformation.

21. Valid Nutrition Information • Nutrition recommendations for the general public are not made on the basis of one study. • Valid nutrition information results from agreement of peer reviewed scientific studies that can be replicated.

22. Freedom Of Speech • Just because something is printed or sold, doesn’t make it valid. • FDA regulates claims on product labels. • Limited in what they can do about fraudulent nutrition information due to constitutional rights of freedom of speech and press. • Nutrition information, whether valid or not, has the same right to freedom of speech under the first amendment as any other information.

23. "Caveat Emptor“ Let the Buyer Beware • Question the qualifications of authors or promoters. • Critically evaluate the validity of nutritional information, particularly if it is used to promote the sale of a product.

24. W’s For Evaluating Nutrition Information • Who? Who is providing the information? Is it a qualified professional. • When? When was the information last updated? Nutrition is an ever changing science. • Where? Where is the information coming from? A government agency, a professional organization, a reputable consumer organization.

25. W’s For Evaluating Nutrition Information • Why? Why are they giving you the information? Is it a public service or are they selling a product? • What? What is the message? Is it in line with other reliable sources?

26. Knowledge: The Best Protection • Knowledge is the best protection against nutrition misinformation. • Consumers need to be able to recognize nutrition misinformation before they waste their money or endanger their life • Consumers need to become aware of the language of nutrition misinformation.

27. Question Products and Materials That: • Claims that promise a quick fix. • Claims made on the basis of one study. • Provide a list of “good” and “bad” foods • Use pseudo-medical terms and jargon such as “energize,” “natural,” “cure,” “detoxify,” “purify” or “cleanse.” • Claim product “secret cure” or “magic.”

28. Question Products and Materials That: • Claim “natural” is better. • Claim food processing and storage destroy all the nutrients in food. • Claim soil depleted of nutrients. • Claim food additives and preservatives are poison.

29. Question Products and Materials That: • Claim emotional stress increases nutrient needs beyond what foods can provide. • Claim products from health-food stores are better than those from regular grocery stores. • Opposed to public health strategies such as fluoridation or vaccinations against infectious diseases.

30. Question Products and Materials That: • Use unproven diagnostic tests to detect nutritional deficiencies. • Claim sugar is a poison. • Claim medical profession is not to be trusted and suppressing treatment. • Claim product has only benefits and no side effects. • Claim to “cure” serious diseases

31. Question Products and Materials That: • Claim product can be used for multiple health problems. • Promote self diagnosis or diagnose nutritional deficiencies based on symptoms alone. • Uses “star” endorsements or “big name” testimonials. • Promotes vitamin and/or mineral doses larger than the DRI.

32. Right To Evaluate • People have the right to evaluate nutrition claims, products and services. • Don’t buy immediately. If a claim, product or service is legitimate it will hold up to evaluation.

33. Credible Nutrition Information Sources • Government agencies that provide reliable nutrition and health information include: • State Cooperative Extension Services • Federal Trade Commission • US Department of Health and Human Services • Food and Drug Administration • US Department of Agriculture • National Institutes of Health • National Cancer Institute • National Heart, Lung, and Blood Institute

34. Credible Nutrition Information Sources • Scientific and professional organizations that offer credible nutrition information to the public include: • American Dietetic Association • American Academy of Pediatrics • American Institute of Nutrition • American Society for Clinical Nutrition • Society for Nutrition Education and Behavior • American Medical Association • American Cancer Society • American Diabetes Association • American Heart Association

35. Credible Nutrition Information Sources • Reputable consumer organizations include: • Better Business Bureau • Industry groups that provide reputable nutrition information to the public include: • International Food Information Council • Food Marketing Institute

36. Websites for Nutrition Misinformation • Check out health-related hoaxes and rumors: • www.cdc.gov/hoax_rumors.htm • www.urbanlegends.com/ulz • www.ncahf.org • www.quackwatch.com

37. References • Position of the American Dietetic Association: Food and Nutrition Misinformation. JADA;2006;106,601-607. • Stephen Barrett & Victor Herbert. Twenty-Five Ways to Spot Quacks and Vitamin Pushers, www.quackwatch.com. Accessed January 2007. • Understanding Nutrition, 10th edition by Ellie Whitney & Sharon R Rolfes. Thomson Wadsworth, 2005. Thomson Wadsworth Publishers. • Understanding Normal and Clinical Nutrition, 7th edition by Sharon R Rolfes, Kathryn Pinna & Ellie Whitney, 2006. Thomson Wadsworth Publishers.