Unchecked: The architecture of disinformation

Episode 10: Disinformation and nutrition, with Dr. Amelia Finaret

• Curious Squid • Season 1 • Episode 10

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Synopsis

For the 10th episode of Unchecked, Rachel and Dan talk to Dr. Amelia B. Finaret, food economist and clinical dietitian about the state of nutrition misinformation. With the release of the latest dietary guidelines – some of which are not founded on sound nutrition science – we take a look at both the classic and newer myths around food. Dan uses the discussion to arrive at the lens of Making Hot Dogs and Rachel applies Diet Culture to our work as UX designers.

Stories

Robert Caro on Robert Moses

AI-Generated Disinformation in Europe

Interview with Amelia Finaret

Lenses

Diet Culture

  • How does the system send signals about the user's "goodness" based on what they are consuming or acting on?
  • How does the system reward “good” behavior and penalize “bad” behavior? 
  • How does the system decide what is good or bad? Who gets to make that decision, whose world view is reflected in that framework?

Making Hot Dogs

  • How does the system process original source material? 
  • What role does it play in the "supply chain" of information?
  • How recognizable is the original source material in the system’s content?

_____________________________________________________

Personnel

  • Dan Brown, Host
  • Rachel Price, Host
  • Emily Duncan, Editor

Music

  • Turtle Up Fool, by Elliot

_____________________________________________________

Unchecked is a production of Curious Squid

Curious Squid is a digital design consulting firm specializing in information architecture, user experience, and product design

SPEAKER_03

In general, just doesn't work to just tell people they're wrong. And they have to kind of discover for themselves what they're wrong about.

SPEAKER_00

You're listening to Unchecked, the podcast about the architecture of disinformation with Dan Brown and Rachel Price.

Dan

What are you doing for Thanksgiving?

Rachel

Oh, Thanksgiving? Or is it Thanksgiving?

Dan

Thanksgiving.

Rachel

Thanksgiving. It's Thanksgiving.

Dan

Now I don't know how I say it. What are you doing for the turkey holiday?

Rachel

I'm not cooking turkey because I don't care for it, but we're hosting about 20 people.

Dan

No shit.

Rachel

Yeah. That's a lot of people. Well, it didn't start off as that many people, but I forgot how many children everyone has. So then it became that many people. Because I guess the kids are invited. We like them.

Dan

So you're not serving turkey.

Rachel

No, we are gonna serve some traditional Lebanese food, some kibbi and some other things, which is lamb and beef. Okay. I mean, my friends know this by now. I'm happy to host, but I will not cook a large bird because I just don't care. So they know that if they are interested in consuming a large bird on that day, they have to bring it.

Dan

BYOB.

Rachel

BYO burb.

Dan

That's good. I like it.

Rachel

Yeah. How about you?

Dan

We're here. My son is coming back from college today, in fact, which I'm very excited about. Yeah, we have uh older set who comes for Thanksgiving.

Rachel

So food that can be gummed.

Dan

It's very there's a lot of shouting, but not angry shouting. It's just that nobody can hear each other.

unknown

Yeah.

Dan

Did we decide I'm doing historically?

Rachel

You're historic because I did not actually do my homework correctly.

Dan

I've been listening to a book called Working by Robert Carrow. He's known primarily for two biographies: one of Lyndon B. Johnson and one of a man named Robert Moses, a book called The Power Broker.

Rachel

It sounds long.

Dan

It is very long. Robert Moses was an urban planner in the mid-20th century in New York City. Much of the topology and contours of New York City are because of Robert Moses. Robert Moses was, I think I can say, kind of a horrible person because he whole hog moved entire neighborhoods, entire blocks of apartments just to make room for the highways and thoroughfares in New York City.

Rachel

So did he apart the water for other things?

Dan

He did not part the waters. Anyway, this book by Robert Carrow is fantastic, and a number of people recommended it to me because it talks about Carrow's writing process. One of the stories that he tells in this book is this was like in the 60s, he was doing research to figure out why Robert Moses had built a highway that went out Long Island, why it didn't go straight, why it had this enormous curve in it. And he was puzzled by this because Robert Moses, in the interview that he had done with him, had said I built everything exactly the way I wanted to build it. And Caro couldn't reconcile this enormous curve in this highway. So he did some digging and he found, surprise, surprise, some corruption. It turns out that the highway would have been disruptive to what they call the Gold Coast, which is kind of the northern edge of Long Island that goes up against the Long Island Sound, and that's where a lot of the robber barons had built their mansions and their golf courses and things like that.$10,000 changed hands, and Robert Moses said, Okay, I'll put a big old curve in the middle of this.

Rachel

Turns out my idea was to curve this the whole time.

Dan

But that story got buried. This was not a story about misinformation, but because I'm listening for that so much these days, it felt like a story about misinformation. And part of it was Robert Moses had cultivated this brand, essentially, of himself, of him being kind of ruthless and uncompromising. And it turned out once we dug below that brand, there was the truth. And the truth was he had a price just like everyone else. And that price was in this case ten thousand dollars. So for me, that was sort of the interesting part of this, of this desire not only to have this view of himself as as completely uncompromising, but the fact that he was able to bury this story, and it took a very careful researcher like Robert Carrow to kind of uncover it.

Rachel

I mean part of framing is suppression of information that doesn't fit in that frame. Exactly. My story is very recent, actually. I'm kind of passing forward some reporting of top misinformation circulations in the EU in the month of October. Very specific. But I found the European Digital Media Observatory or EDMO is this project that supports the independent community working to combat disinformation. And so every month they do like a fact-checking roundup to report on what's circulating, where things are coming from, and the kinds of patterns they're seeing around the EU. So October's report headline is this in All Capitals. So AI generated disinformation hits a new record in October as information integrity crumbles. Wow. Like cue, my surprise to face, right? Right. So uh EDMO maintains a fact-checking network, and each month that network publishes a pretty large set of fact-checking articles that EDMO analyzes for patterns and disinformation. And so based on the reports this month, they list out the four false stories with the widest circulation in the EU. I'm gonna read them to you. The first is AI generated content of Hurricane Melissa and the related destruction there. The second is an AI-generated image of Zelensky wearing platform shoes. Third is AI generated videos of the theft at the Louvre. And fourth is a story about a UK teenager arrested for waving a UK flag. When you zoom out and look at this stuff, you can kind of scoff at how obviously ridiculous this stuff is. But like two of them, like the Hurricane Melissa and the theft at the Louvre, breaking news where there's a vacuum of information. Right. And not only is disinformation filling it, but like AI generated disinformation can fill it real quick.

Dan

Was the finding of this organization that people not just circulated it, but there was evidence that people believed what they were seeing as well? Because it's possible they were circulating it because they were like, look how screwed up this is.

Rachel

Yeah, I don't know. That's a good question. One more thing from this report that I thought caught really captured my attention is one misinformation story that Edmo has marked as quote significant at the national level is the story floating around the country of Cyprus claiming that the 15-minute city model, which are you familiar with the 15-minute city?

Dan

I am not.

Rachel

So this is a model of walkable and bikeable cities with decentralized networks of workspaces and shopping. You know, like you should be able to like live your life within 15 minutes of your home. Anyway, the disinformation story that is significant in Cyprus right now is that the 15-minute city model is actually a government scheme for total population control.

Dan

That's amazing.

Rachel

That was a new one for me. And then I actually did a little digging, and apparently there's a lot of controversy around this 15-minute city idea, which I didn't dig into for this episode, I might bring it back to dig into later because I had not uh come across that theme of misinformation before, the 15-minute city one.

Dan

I'd be really interested if this rises above the level of conspiracy theory. There's something to be said for you know being able to do everything within 15 minutes of your home, if I'm honest, my childhood growing up in Manhattan. That was pretty much true. I could walk to school in 15 minutes. That was the longest thing I ever needed to do. But I can't imagine sort of like what's the nefarious I can understand people imagining it's nefarious.

Rachel

I can imagine if people think it's about suppression that it could feel nefarious, but let's put a pin in this. I have a lot of questions about that one.

Dan

We're about to talk to Amelia Fineray, uh nutritionist. I'm really excited to talk to her.

Rachel

Yeah, this is a great one. Today we get to talk to Amelia Fineray, who is an associate professor of global health and economics at Allegheny College in Meadville, Pennsylvania. She's also a clinical dietitian at a local hospital seeing patients with diabetes, eating disorders, growth problems, cardiovascular disease, and obesity. She's the author with Will Masters of the textbook Food Economics, Agriculture, Nutrition and Health. And her research focuses on data quality for large-scale nutrition surveys, the health effects of foods, and the economics of malnutrition. Thank you so much for having me. Obviously, we invited you here with a lens around your work and misinformation, seeing how those things intersect and kind of your perspective on that. So just give us a little bit of background here. How does misinformation kind of intersect with your work?

SPEAKER_03

So the main way that misinformation about nutrition intersects with my work is through having my patients tell me things that I can tell are from somewhere else. The things that they tell me really vary a lot. Diet trends definitely come and go. And there's been diet trends forever. It's not a new thing, right? And there's also been misinformation about food and diets and health for a long time as well. But what I see is mainly three main categories of things that I hear from patients. Some of the misinformation I hear is, you know, not super problematic in terms of health problems that it might cause if you were to employ this advice. Slightly wrong, but not really that harmful to people. Another category is outright harmful stuff. Like if you do this, you could hurt yourself in some way. And then another category is misinterpretations of the scientific literature and also bad science, too, that's out there. And there's a lot of both of those things. For some examples about the first category of, you know, kind of benign misinformation about nutrition are things like coconut water being more hydrating than water, right? Yes, coconut water has electrolates. So if you are deficient in some electrolates, then coconut water will help you hydrate faster than just drinking plain water. But if you just like eat food and drink water, you also get electrolytes from your food, and then you can drink the water, and then you don't actually need to buy the coconut water, and you'd be perfectly hydrated. So it's not like a harmful lie, but it's one of those pieces of misinformation that's kind of getting us to buy things, which is going to be for sure a theme. Things like juice counts as a fruit serving. That's not gonna be harmful to people, but it is making them think about fruit in a way that is not exactly correct because when you take it out of its matrix with all the fiber, then the nutrient properties really do change. Or things like honey being healthier than sugar, they're the same. They're just the same. Honey is not healthier than sugar, you know. Maybe I wish that it was, but it's not. So those are kind of our benign things. The things that are more dangerous are dietary patterns that restrict food groups. So, for example, the carnivore diet being very high in meat and animal sourced foods and very low in plant-based foods. It's being touted as something that can prevent disease and improve longevity and reduce obesity, but it really does come with a lot of harms. Not enough fiber intake, not enough vitamin and mineral intake. Other things are kind of even worse, like that you should take megadoses of vitamin A to prevent the measles. And this is a really tricky piece of misinformation because it's absolutely true that in contexts where children are deficient in vitamin A, they need vitamin A to prevent them dying from the measles. And there are programs for vitamin A supplementation with megadoses twice a year every six months that provide that vitamin A, and then those kids have reduced risk of dying from the measles. So that's real. But it's not the case that for people who are not deficient in vitamin A, they need to take megadoses of vitamin A, and that will help prevent the measles. That will not happen. And then in terms of statistics and the studies that are out there, there's a lot of nutrition studies. It's sometimes easier to do research on nutrition and dietary intake than on other inputs to your health. Because even though it's hard to measure dietary intake, people can still talk about it and they understand what a survey is about it. It's low cost, right, to do a survey about what people are eating and kind of figuring out how healthy they are, and then you can do some correlations. But it's really hard to do it well. But then, you know, you see these headlines that's like, oh, well, if you eat this, then you'll be healthier, and that's very tempting. So I think in general, there's so much misinformation about individual foods. And so one category there is about superfoods. So someone will ask me, like, oh, well, if I eat kale, then I'll be healthy, right? Yeah, kale is a great food. If you eat it, then it's good for you, it's gonna provide you some good nutrition. But that doesn't mean that you're going to cure diseases with it, that your life is going to be changed because of it, that it's somehow some kind of superfood that's gonna make you a superhuman, right? Superfoods are just a marketing term that is designed to kind of get us to buy more and different things. Like I said, it's one of the things that is happening with these misinformation trends is that it's getting us to buy stuff.

Rachel

Oh, interesting. Okay, we're gonna come back and talk about that in a minute. One thing I'm hearing seems like there's this pattern of context and nuance, right? Whereas you explain the myth, you're like, well, actually, like there's these other things happening around this, or that strips the context in which this food exists. Does that feel fair?

SPEAKER_03

Yes. Nutrition is one of those things that has to be understood in context, and otherwise it makes no sense. Because if you say like an apple is healthy, well, sure, an apple has soluble fiber and it has vitamin C and has calories, that's good too. But you don't know whether an apple is healthy for someone unless you know what their context is. And this is the case, especially for foods that people might be allergic to, or that if they have medical conditions that make it harder for them to eat things like apples, then that apple would not be healthy for them. So context is the only thing that matters. You know, you could eat any individual food today and it wouldn't have any effect on your health as long as you're not allergic to it, or if it has a foodborne illness, right? As long as that's not the case. Any food you eat is healthy anytime. But it's only the long-term trends in context that matter for actual production of your health over time.

Rachel

Yeah, it feels like staring at a specific tile versus stepping back and looking at the whole mosaic, right? That's two very different things you're looking at. Where do people get their misinformation?

SPEAKER_03

I mean, sometimes I ask people this, but I don't collect data on it. I know that social media is a big culprit here. This is where a lot of people get their news in general, but especially tips about how to be healthy. There's also just journalism that, you know, could benefit from being higher quality when it reports on new scientific studies. And I think scientific journalists are amazing. There's a lot of amazing ones. A lot of them do great work, but there's just not enough of them to report on all this stuff appropriately. So, you know, you end up having an article which is saying, like, oh, this study said that if you drink this particular tea, then it can help control your blood sugar, but it's not giving you that other context that might be really helpful because the journalist is too busy or they haven't been trained in scientific journalism or whatever is the case. And people also get nutrition misinformation just at the store. Oh, tell me more. So at the store, there are laws about how food companies can label things, but there's a lot of wiggle room for them to be able to label things in certain ways. So then if we see something like a supplement bottle that says like immune boosting, then we might think like, oh, that's gonna help my immune system.

Rachel

Yeah.

SPEAKER_03

And that is most likely not the case at all, that that would help your immune system. So just the labels that we see at the grocery store, at the supplement store, that's a form of misinformation as well.

Rachel

Oh, that's so interesting. You know, Dan and I have talked a lot about digital information environments. Sometimes that can be very abstract and gets old. Now that I'm thinking about packaging and this analog information environment in the grocery store.

SPEAKER_03

Yeah, and I mean for the grocery store, it's not even just analog anymore, right? Because a lot of people do buy their groceries online and they buy their supplements online. So, like Amazon and Walmart.com and all of the online marketplaces that people buy things at, they have images and they have descriptions, and those are digital spaces too. So I think there's a section there that really is important for this particular question.

Rachel

You know, when something is printed on packaging or included as part of a product description online, it feels authoritative, right? It feels like, well, they printed it. So this is kind of leading me into my next question. These myths and these beliefs are pretty pervasive. Do you get a sense of why folks latch on to these myths?

SPEAKER_03

So I think food and what you choose to eat is a very personal thing. It's something that people want to have a lot of ownership over if they can. And so if you end up kind of criticizing what someone's chosen to eat, it can feel very personal. It's something you're putting into your body, and you know that it contributes to your health status. Even if you don't know how exactly, that doesn't matter. You know that what you eat matters for your health over the long term. So anything that is telling you this is how you can be healthy and this is how you can avoid being unhealthy is going to be very tempting. You know, there's some common kind of trends or patterns in the misinformation, like about how things that are natural are better. And that is like something that people really latch on to. They love the idea that we can prevent disease, treat disease with food. And while that is the case, in some ways, you can do a lot of disease prevention by addressing dietary intake and improving dietary quality. You cannot cure diseases with what you eat, and you cannot always prevent disease with what you eat, but it is a nice feeling to be able to kind of think that for yourself. So another reason would be I think that people feel like they have more agency over what they eat compared to other inputs to their health. Like other inputs to your health are gonna include how many hours you sleep, your safety at work, whether you have a dangerous job or not, your educational attainment, whether you have a primary care doctor, whether your income is higher or lower, whether you have a supportive and enriching social life with family and friends and loved ones. All those things are, I think, harder for people to obtain and conceptualize obtaining as inputs to their health compared to food. Because like you have to eat every day, right? Yeah to get food. So it's something that you have more maybe control over compared to those other inputs. It's also kind of easier to experiment with. So like you can experiment with a new dietary pattern and see like if it works for you, whereas you can't really do that as easily with other inputs to health.

Rachel

Food and nutrition is so fraught, especially I think in American culture, we tend to associate a lot of morality with what you eat and merit and morality with how you look. I say this as if I'm a third-party observer. I'm a woman in America, I don't get this sense. I know. I know that if I don't question my perception of this narrative, then I believe that the food I choose is a reflection of how good of a person I am and how much I am worth in this society. We talked in the pre-interview that this isn't just about nutrition. This isn't just about physical health. There's a lot of psychological and social components to this too.

SPEAKER_03

Absolutely. And what you're talking about is diet culture. And diet culture is harmful, you know, like you said, to our psychological health, to our physical health, because what it does is it tells us if you don't eat a certain way, then you have done something wrong and you need to fix it. So then what ends up happening is people go in these cycles. And it might happen over the course of a day or over the course of weeks or months where they have restriction of what they're eating, and they go and they do certain dietary patterns that are kind of extreme. And maybe it helps them with whatever goal they have, or maybe it doesn't, but then eventually they're gonna go back to where they were not restricting, and they're gonna then have the swing of shame and then going back and forth. And the going back and forth with weight in particular has been found to be harmful, you know, as opposed to kind of staying at a stable weight, even if that stable weight is higher. So the swinging back and forth that is really driven, I think, by the psychology and by the exposure to diet culture is a huge source of harm.

Rachel

Yeah.

Dan

You said something earlier, Amelia, that I'm still thinking about. And it's just a simple phrase. You said food is personal. I like that framing, but I feel like I grew up with that. completely different, let's call it, flavor of that phrase. And that was uh you are what you eat. I've been hearing that ever since I can remember. Here's my question and it's probably more philosophical than anything else. Do you think you are what you eat is the most egregious nutrition misinformation that we have?

SPEAKER_03

It's definitely up there. You know, really what that phrase is doing is equating food intake, which you have to do to live, with your morality and who you are as a person. But those things really have no reason to be connected at all, scientifically speaking. You don't really want to think about something that you have to do for your health as being determining of who you are as a person. But that also drives a lot of how our food system looks and why we have so many different tiers of food system quality and access where you know we've got organic farmers markets on the one hand and on the other hand we have like big box stores and the products are all different. You know you have like a regular version and a premium version. Like all of this is related to this idea that you are what you eat. So I better eat right and that usually means spending more money on something that you probably don't need at all.

Dan

Or being a citizen of Seattle or that I shop here at this grocery store therefore I am a better person.

SPEAKER_03

Right.

Dan

And I belong to a certain socioeconomic class and therefore I am successful as a person.

SPEAKER_03

Right. It's a really powerful way to signal what you eat because you do it all the time and you do it socially often and you might do it in front of your coworkers or your friends and so it's a big signal and it's an important part of people's identity. So I don't want to say that it's it's a useless thing. Of course it matters to people and it it should matter but a lot of the things that people end up latching onto are things that actually don't matter if you were to look at say the environment or the health factors or the animal welfare factors, right? Those are all really important things and there's a lot of science behind all of those categories in terms of what really matters from the food system and also what is not really a problem. And there's a lot of other misinformation about that stuff that I'm sure you guys could get into one day.

Rachel

Okay so I think this conversation has really unearthed the fact that you Amelia are up against a lot when you're in a conversation with a patient who is bringing you nutrition disinformation, what techniques have you used to try to dislodge some of this misinformation?

SPEAKER_03

I think the first thing to say is that I I don't ever want anyone to feel bad, like feel like they've been duped or whatever, because that's never a good feeling. Figuring out what to eat to make us healthy is is not like an easy thing necessarily and a lot of different entities are trying to influence us in one way or another but there are some red flags to look out for that I can talk to people about. If they feel very fearful about what they've seen, then I think that's a signal to them. So I can bring up to them, okay, well did you feel very strongly when you saw that and how did that make you feel and if they felt that kind of strong disgust or fear about something they saw then we can talk about sort of where that fear is coming from and why you know it might have been manipulated. In general remembering that food is personal remembering that people are not going to easily take criticism of their food choices lightly. So asking questions like okay so that's interesting that you chose that can you tell me more about that really validating their concerns about like okay well they want to be able to control their blood sugar they want to be able to avoid having a heart attack they want to be able to walk around their house without pain in their legs whatever it is they have goals right so validating their concerns that like yes this is a serious thing that you're dealing with and we want to address it. So can you tell me more about this thing that you heard so a little bit of like motivational interviewing instead of me telling them what to do instead kind of asking them like so what do you think you could do to address say the salt intake that we talked about? Are there foods that you think are high in salt that you eat that you could reduce your intake of or change the type that you're having so asking the question instead of telling I think is really helpful. And also maybe a little bit of Socratic questioning too but in like a nice way because I think it can be kind of in a mean way sometimes so say we have like a claim about nutrition that someone is kind of repeating to me I would ask them okay so what are some questions that you want to ask yourself about this claim or about the person making this claim what else do we need to know about this before we kind of move forward with this or what did this person say that made you trust what they were saying? What kind of credentials do they have? Or like what kind of research did they talk about behind that claim? Do you feel confident in that research? Should we look it up? Or like since trying this diet is your life better or the same or worse where is it taking you?

Rachel

Yeah.

SPEAKER_03

Or you know kind of getting them to go a little bit meta like okay well remember when like the Atkins diet was a big craze like I wonder what happened to that one like now it's the paleo diet or the carnivore diet like whatever happened to that other one I wonder if these don't actually work otherwise they would stick around. Yeah sometimes I go for demonizing the food companies because that's something that all of us I think can get behind. And I don't want to always demonize all food companies because they produce great stuff and they do good things, but they also have problems. So I might remind patients that these are profit driven companies they do not care about your health they want everything in your wallet and they want you to buy what they're selling in general just doesn't work to just tell people they're wrong. Yeah. They have to kind of discover for themselves what they're wrong about like how might your bowel movements change if you try this carnivore diet would you be concerned about anything related to that.

Rachel

I hear you in describing this creating space for guided inquiry right and taking a pause and asking people to just ask a couple questions rather than you swatting down ideas because you know they're wrong.

SPEAKER_03

Yeah that's the goal and it does take more time to do it like that but I think it is more effective. Yeah.

Dan

There's this distinction when you eat food of how it makes you feel when you eat it and how it makes you feel later. And in some ways that's kind of a perfect metaphor for misinformation as a whole because sometimes we latch onto a lie because it makes us feel good in the moment because it answers a burning question like why did that plane crash? Right? Okay now I've got a lie that I can latch on to and now I feel satisfied that I have some knowledge about it. But in the long run there is harm just like I might eat something now that makes me feel really good and down the road a few hours from now it makes me feel bad. I think a a large part of what you have to do as a nutritionist is to help people see that bigger picture. You talked about sort of patterns of consumption two patterns of eating helping people see themselves not as just going from one meal to the next or how an individual meal makes them feel but more long term, a wider view. What does that conversation look like in terms of getting people to take that longer view?

SPEAKER_03

Yeah I I totally agree with you and I think most dietitians and nutrition professionals would that there are really kind of two moments of really how we're going to enjoy our foods and one of them is when you're actually eating and then the next bit is afterwards and both of them really matter because if we don't have both being positive experiences then what's going to happen later is the person's going to compensate for that by trying to enjoy something in a way that is quick because they didn't get real satisfaction they actually needed from the meal before. So I talk to people about really trying to maximize their enjoyment of any given meal or snack because if you don't feel that in your body like okay I got all these food groups and I had a large volume of food. So the chewing and the time I had to take to eat it like I felt like I was eating for a while like I didn't just wolf something down in two minutes and you know it's an hour later and I'm still full and I feel like I'm still ready to go and so aiming for that feeling regularly is the most important thing and it's all about enjoyment. Enjoyment also happens to come with more food groups in one meal right because you've got different textures you've got different flavors you've got maybe different temperatures even different food groups. More food groups means more nutrition packed into one. So yeah the more that people can have a pattern of food enjoyment which is the short term immediate like yeah this is tasty in front of me but also I feel good for hours later and I feel like I'm fueled up for hours later, the longer they can sustain whatever dietary pattern that is and if they don't like it, they're not going to keep doing it. I tell people all the time you have to like it. This has to be actually positive for you if you are going to keep doing it. So if you're the kind of person who needs to have dessert every day, like plan that in. Plan it. Don't just not ever eat dessert. That's not going to work.

Rachel

It's like how uh realistic budgeting advice is like write down the actual budget that supports your life and your dreams and not the aspirational budget that leaves you feeling disappointed and ashamed of yourself every month. Exactly so we've talked a lot about individuals and nutrition and misinformation I want to take us up a layer of altitude. We started to discuss media a little bit I'm also then thinking about policy, you know like governmental policies and how this kind of ladders up so we hear individuals who are dealing with or reacting to or interpreting misinformation. How does that misinformation trickle down? Like who do you see as being kind of the players in that like middle layer and upper layer what's your interpretation of kind of that framing that space?

SPEAKER_03

It depends on the specific nutrition misinformation. There's a history to all different myths about nutrition and and I I don't know all of them, like where they all came from but you know a lot of it does start with scientific studies that are not necessarily lower quality but they were done with methods that we don't need to use anymore because now we have better methods or they were done with data that was imperfect because we didn't have better data. Overall just because we keep discovering new things in nutrition does not mean that there aren't like principles that we are all kind of agreeing on. So there are new discoveries but it's rare in nutrition for there to be like breakthrough studies because these principles are all kind of agreed upon. So when it comes to policy the biggest way that nutrition research influences nutrition policy in the US is through the dietary guidelines advisory committee. This is a committee that's convened every five years to create the scientific report that then informs the development of the dietary guidelines for Americans. So the Dietary Guidelines advisory committee submitted their report to the Health and Human Services Secretary Robert F. Kennedy he has said that the typical dietary guidelines for Americans report that then is written out of that is too bloated and he is considering wanting to advise people to eat more saturated fat, eat more whole fat dairy versus low fat dairy, maybe promote the carnivore diet. He's also mentioned other things like promoting more whole foods and so that's kind of less of a concern but I'm not sure how telling people to eat more whole foods without trying to fix the food environment or people's purchasing power would really work well. So this structure really is this committee writes the dietary guidelines advisory committee report they're all experts they review all the relevant scientific literature and it's a huge huge job. So they write their report it's 400 pages long it has a thousand page supplement and then the government comes through and writes there you know 150 pages or so of the dietary guidelines for Americans and then the government also comes and creates websites for the public to come and explore these dietary guidelines. So right now the current dietary guidelines were published in late 2020 and they came with a website which is myplate.gov and this is a consumer-facing website you can go through and do meal plans you can pick the number of servings of fruits and vegetables you can select your sex your age your life stage your body size your desired calorie things like that and you can make meal plans there. So it's an easy to use system and it already exists so I understand why Secretary Kennedy wants to make nutrition advice more digestible right I get that but it does exist in this myplate.gov for the consumer facing piece and the dietary guidelines for Americans report is really supposed to be for health professionals and policymakers. So for health professionals and policymakers they use this in order to inform how programs like the National School Lunch program, the school breakfast program, the child and adult care food program and the WIC program all operate. They also inform food service institutional food service for the military and for some prisons is guided by the dietary guidelines for Americans. And health professionals also use the dietary guidelines for Americans as a foundation for nutrition advice for education to patients. So I hope that we can continue to do this and I hope that the dietary guidelines for Americans are based on the sound science that was reported in the dietary guidelines advisory committee report. I hope that that kind of stays being the system and I would be concerned if it didn't.

Rachel

Yeah it sounds like there's this core source of information that is extremely contextual and nuanced and detailed that in relatively recent history has successfully trickled out to policies you know to some degree policies and individuals. And now we're looking at a moment where that information is uh maybe not being used to inform the policies in the way that we would like to right we'll we'll see what happens.

SPEAKER_03

The last I heard he said that the dietary guidelines for Americans were going to be four pages long. So there might need to be four pages information there. Because right now the report from 2020 the dietary guidelines for Americans includes information for all different ages and life stages and it's very helpful for health professionals to have that information.

Dan

There's more than four food groups that's not even one page per food group.

SPEAKER_03

Right.

Dan

That's very disappointing this myplategov is a phenomenal website I see this and I'm like this is exactly what the government should be trying to do which is yes they have to do all that research work but then make it accessible for people and as many challenges as we've got with nutrition in this country it's nice to see stuff like this.

Rachel

You know one of the interesting things when I think about my plate I believe it was uh Michelle Obama who took this on uh which took us from the food pyramid to my plate.

SPEAKER_03

So Michelle Obama spearheaded the update to the National School Lunch program and the school breakfast program and made both of those programs have healthier foods with more fruits and vegetables for kids. That's amazing and that was huge. That was the Healthy Hunger Free Kids Act which I think was 2009.

Rachel

Yeah where we can see this application of this core information you're talking about. Yeah it's interesting you know the thing I was thinking about is we need to acknowledge that politicians take this content and use it to do things all the time. Some of those things uh seem more helpful than others like trying to keep a straight phrase because obviously my plate is significantly more helpful than a four-page RFK issued guideline. You know when I hear someone complaining that something is bloated that makes me raise an eyebrow because it feels like suppression of information to me.

SPEAKER_03

Right, exactly because making dietary guidelines for a whole population is very hard. Even though everyone needs all the same nutrients we all need them in different amounts based on various factors and there's lots of factors. And not only that but there's different ways to get nutrients from different food groups and balancing all that out is really important. So if you're going to advise an entire population on how to eat food-based dietary guidelines, which I think are very helpful, then you definitely want to have a complete picture because you don't want to leave anybody out. That's really important for people to feel like they're represented in those dietary guidelines because of course it's very easy to also complain about them like well I'm a vegetarian or well I hated the food guide pyramid. I'm not going to do this myplate thing either well yeah there's always going to be challenges. I think it's very important in that case for the process to be very transparent. Like you can see all the citations in the dietary guidelines advisory committee report they're all there supporting their findings it's a great translation of the science to have myplate.gov there too.

Rachel

So this segues me really nicely to my next question which is if I were a patient in your clinic and I wanted to know the best source for kind of consumer level nutrition information, where would you direct me?

SPEAKER_03

Yeah that is a great question. So besides myplate.gov, one of the greatest nutrition minds of our time is Marian Nessel. She's at New York University. She has a new book out very recently called What to eat now. It's an update to her book What to eat which was 2006 and it's really going to be perfect for people with or without chronic diseases to figure out what to eat and she's really a trusted source. She is skeptical of those labels that we talked about on foods and on supplements one thing that she has said is that the more it's telling you that it's healthy for you, the less healthy it is, right? Yeah. So another great source is the Academy of Nutrition and dietetics which is eatright.org. I don't love the name but that's the name of the website they have a new initiative they're doing which is nutrition fact check. And so they have some good stuff on their website with kind of trending issues. Another source if you're looking for more like detail on a certain vitamin or mineral or nutrient or diet Harvard has a website called the Nutrition Source. They've got a ton of detail on all kinds of topics in nutrition and it's cited and it's all right there. If someone's looking for recipes then I would recommend the American Diabetes association not because everyone has diabetes but like anyone can benefit from diabetic friendly recipes and they have a lot of great recipes on that website. They also have free cooking classes virtual cooking classes.

Dan

Very cool. My assumption is that maybe because of some of these policy changes you can almost anticipate some of the questions that you're going to get in the clinic like okay these goofballs are saying X Y and Z, so next week in the clinic or a month from now in the clinic I bet someone's going to come in and ask me about X, Y, and Z. Now it's possible given the state of social media and how information works these days, it almost goes the opposite way, which is someone latches on to what they think of as an interesting idea and that becomes kind of the next big trend in nutrition and so you can't anticipate that as much. But my question is what are you anticipating coming down the pipe? Like what sort of misinformation are you sort of gearing up for girding yourself for?

SPEAKER_03

I am thinking that people are going to come to me saying that more higher fat animal sourced foods are healthier. And while it's okay to have fat from animal sourced foods it is something that for a lot of people who are at risk of chronic diseases you do want to reduce. So I'm going to have to figure out how to talk to people about fat from animal sources which is mainly saturated fat. I think I'm going to hear a lot about seed oils also because that is definitely the demon of the oils right now and of fats in general. It's coming for us the seed oils they're coming for us and really that's a concern too because a lot of seed oil sources when used in certain ways are healthier than fats from animal sources. So I'm concerned about fats and the sources of fats a lot. Whole fat dairy in schools is going to be a question too whether they allow to have whole fat milk in schools right now it's low fat or fat-free. And and that is actually an interesting debate and I don't think that there's a way to kind of say yes or no we should have whole fat milk in schools or not like there needs to be a proper study done about it.

Dan

But I think fat fat is going to be the thing and possibly dietary patterns like the carnivore diet too if I had to drink full fat milk in school at lunchtime I would not be able to pay attention in any of my afternoon classes.

SPEAKER_03

Because it would make you sleepy?

Dan

It would have a variety of effects that would make it very difficult for me to concentrate.

Rachel

See I grew up on a dairy early days so when someone puts skin milk in front of me I just walk away I don't understand.

SPEAKER_03

It's water okay so Amelia we like to end as much on a high note as we can what's giving you hope right now so when I talk to people they really are interested in improving their health a lot of the times they're scared about a new diagnosis or they're worried about how their kid is doing and whether they're going to get made fun of for being fat at school and it's like really hard. This is like hard stuff. But then you know they are also really interested In trying to change what they eat in order to be healthier. So even if it does take extra time to talk to them about misinformation that they're exposed to, I'm really hopeful for that. And I'm also hopeful because my students are learning about this stuff too. And they're really interested in trying to improve public health in various ways, including through reducing the impact of misinformation and disinformation in the health system. So I think basically my patients and my students make me hopeful. That's incredible.

Dan

Thank you so much, Amelia. This was really great.

SPEAKER_03

This was really great. You guys are awesome.

Dan

I was excited to talk to Amelia about nutrition misinformation. And that conversation so far exceeded my expectations. What Rachel lens did you draw from that conversation?

Rachel

My lens is called diet culture.

Dan

Oh, that's a good one.

Rachel

And you may be wondering how does diet culture translate to any kind of IA lens? So this lens asks us to interrogate how does the system make the user maybe feel better or worse about themselves based on what they're consuming in that digital environment, what they're reading, what they're doing, or what they're acting on, what actions they're taking. How does the system reward, quote, good behavior and penalize, quote, bad behavior? How does the system decide what is good or bad behavior? Who gets to make that decision and whose worldview is reflected in that framework?

Dan

Wait, let me reflect this back to you, make sure I understand. So diet culture as a thing has sort of built this set of expectations around how we behave, what we eat, what we should look like, all of that kind of stuff. And if we treat that as an analog to an information space more generally, information spaces could potentially impose a set of expectations on its users, in a sense, creating a sense of shame where none should exist. Yeah. Based on users' behaviors and how they understand the information coming out of it and what kinds of expectations it puts on the users. Did I get that?

Rachel

Yeah. I think that it's like the antithesis of a gamification pursuit. I hate gamification of experiences. I think I can say, yeah. When I think about why I hate it, it's because it's so explicitly like trying to get people to do a thing and then make them feel good about doing it. And then you have to wonder, okay, what about the opposite though? Right. Then you are trying to make people feel bad for not doing the thing. Right. And who gets to decide what good or bad is? The thing I really like about this lens, first of all, is that I'm very passionate about trying to call attention to the dangers of diet and wellness culture in other realms of my life. This is a thing I spent a lot of time thinking and reading and talking about. But this is also kind of a mega lens that combines a bunch of things. Like I started with like, is this about disgust? Is this about shame? Is it about incentivization? Like, I think a lot of previous lenses we've talked about kind of roll up into this. Yes. And when I landed on this kind of diet culture lens, it felt very useful to have this kind of roll-up philosophical question of like, why are you trying to make people feel good or bad about the behaviors they're taking? And who decided which behaviors are good or bad? Like, whose worldview is that representing? You know, we exist in capitalism, businesses are going to make decisions about behaviors they want to foster. This lens is about like developing an awareness for that and at least interrogating that idea of like, okay, cool, whose worldview are we promoting here? And like, are we okay with that?

Dan

I'm thinking about this in the context of like an enterprise application. For example, I need to submit expense reports, right? There may be an instinct to make people feel bad for not submitting their expense reports on time, but if we interrogate that and go, wait, why do we want people to feel bad? And can we turn that on its head and instead ask, what can we do to support people in achieving this goal? Can we help people understand why this goal is important? We are looking at the system as a way of providing support and help by being more transparent about what the need is.

Rachel

Yeah, I love that. I think gamifying the behavior you want is not necessarily harmful, but the absence of not shaming the behavior you don't want, yeah, I think is the subtler thing that absolutely happens. It's like paired with it. Right. And no one's going into meetings talking about how we're gonna make people feel bad because they didn't get the badge. But you know, that's kind of what you're doing.

Dan

Right.

Rachel

What's your lens, Dan?

Dan

Something that I decided to call the lens of making hot dogs.

Rachel

Please tell me more.

Dan

Yeah, I don't eat hot dogs myself, but I understand that the process of making hot dogs is gross. And the thing about a hot dog is that its source material is virtually unrecognizable. And when we were talking to Emilio, we were talking about this kind of core set of dietary guidelines that is created. It's like this big report that comes out every five years, and that informs and filters out to other venues, other places where the information in that core document is interpreted appropriate for that venue. So we talked about school lunch guidelines or myplate.gov, right? So the single document ends up informing all of these things. And, you know, it's six degrees of Kevin Bacon, right? We can sort of look at myplate.gov and connect it back to this original document. And it got me thinking about how a lot of disinformation is manipulating source material. And part of that manipulation might be that it's so far removed, right? It's kind of gone through a game of telephone, for example, or it's been changed beyond recognition in some way. And so they're simply referencing the source document without really, you know, making use of the of the source document. So the idea of making hot dogs is really asking how does the system process original source material? And what role does it play in, let's call it, the supply chain of information? Does your system serve as a means for making that original source material as accessible as possible? Does it exist as a way of interpreting the original to be more appropriate for an audience, or does it end up being as very far removed from that source material?

Rachel

My mind just went right to LLMs, large language models, when you said that. And I like cried a little bit on the inside. Because LLMs are just hot dog machines.

Dan

They are just hot dogs. You know, I didn't even freaking think about that when I came up with this. But I'm so glad you said it. If there is source material, it's completely unrecognizable. And because of that, because of the way the LLMs work, there's hallucinations. So we don't know exactly what they're getting right and what they're getting wrong.

Rachel

Yeah. When you first started talking about this lens, I immediately started thinking about citation chaining. You know, when you're reading research, if you found an article or whatever that is like really touching on some things that you want to dig deeper into, a good thing to do is go down and follow their citations. And then you keep, you know, going deeper and deeper and deeper. And this is citation chaining. Following that breadcrumb trail is such a great way to get source material, like primary material for answers. I mean, I'm a huge nerd. I find it deeply satisfying to do that. It's really fun when you discover that stuff. And so I was thinking, like, how do you bring that joy of citation chaining? Like, if you're a nerd, that spark of joy of like tracing knowledge and watching ideas unfold, researcher to researcher. How do you bring that into a system in a more accessible way for more people? Right. That kind of act of yeah, connecting back to the root sources and tying this whole web together and like seeing how things make sense from primary material. Uh, this is a really cool lens.

Dan

I think the idea too is even if it needs to go through a lot of processing, that it should be transparent. So even if someone chooses not to be nerdy on that particular day to follow the chain, building their confidence by showing them that such a chain exists rather than hiding it altogether, I think is a big part of that.

Rachel

I'm gonna tie this back to diet culture again. Like processing isn't inherently bad. Yeah. There are purposes for processing food and processing information. You just want to be able to trace it. Right. I kind of want a hot dog now.

Dan

And that was unchecked. Thanks so much for listening. We really want to hear from you. If you've got ideas for topics or guests or stories, drop us a line at unchecked at curious-squid.com. If you made use of the lenses that we described today in your practice, we want to hear about that too. Hey, check the show notes for any of the links that we talked about today. And it would really mean a lot to us if you shared this episode with a friend and rated and reviewed us on your favorite podcast platform. Thank you.

Rachel

The day this podcast makes money is the day I cook a turkey.

Dan

Oh, Emily, that needs to go in the episode somewhere. Just make that like the tag at the very end.

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Dan Brown

Host
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Rachel Price

Host
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Dr. Amelia Finaret

Guest