As a generally professional and mild-tempered individual I was quite shocked to find myself locked into a bit of a “brawl” on Twitter a few days ago with Mr Ben Goldacre. Goldacre is famous for his highly skilled and entertaining attacks on bad science, with incredibly insightful dissections of poor experimental design, the misuse of statistics and false medical claims. The nutrition profession in particular has been frequently challenged by Goldacre, who has relentlessly pursued of the quacks, charlatans and downright crooks who prey on the public in the name of nutrition. On the one hand Goldacre is on the same side as the academic/professional nutritionist in that he despises false scientific claims and people making money out of advice which is at best nonsense and at worst dangerous to health. However, on the other all nutritionists tend to be tarred with the same brush in Goldacre’s hands and the learned societies which make up the nutrition establishment in the UK (BDA, Nutrition Society, AfN) have not always responded to Goldacre’s complaints and issues in a full and timely manner.
So, why the Twitter brawl? Well, I came across a statement from Mr Goldacre that basically amounts to “nutritionist=quack”. His contention is that the public now so firmly associate the word nutritionist with “person making schmaltzy public claims about diet, selling diet books and pills, offering charismatic personal consultations with wildly specific advice”, that those of us who work in academic or clinical settings have lost ownership of the word nutritionist and need to think about calling ourselves something different.
Is he right? Well maybe if we were to take a random sample of the general public we would find a majority which reflects this view. The majority of people have never encountered a dietitian and will be blissfully unaware of the academic nutritionists who provide the evidence base that underpins contemporary health promotion and population-level dietary advice. However, whilst the public may associate the word “nutritionist” with individuals spouting non-scientific nonsense and spruiking supplements to go with their latest diet book, we would also find that they are aware of the need to consume less salt, to control their body weight and to eat their five-a-day. We have not lost this battle. Although the charlatans will bank their ill-gotten gains, their prey are the minority.
More importantly we could argue that the issue Goldacre has identified applies to almost any respectable scientific or medical discipline. The views of the public are influenced heavily by the media that they experience and unless they come into contact with practitioners they are unlikely to have a good understanding of the real science. Under the influence of TV soaps and dramas, the UK public may well be under the impression that midwives spend more time cycling and mingling with nuns, than delivering babies; that surgeons plot their complex love-lives over an open chest cavity and; that pathologists spend their working hours in direct pursuit of terrorists and murderers, whilst simultaneously offering care and counselling to bereaved relatives. It is perhaps pertinent to consider the eternal confusion between astronomers (scientists) and astrologers (quacks) which has never been adequately addressed in public perception. Should we therefore be confused that for some people in our society nutritionist does equal quack. We are not alone as a profession!
Personally I do not agree with the Goldacre thesis on this. Nutritionists should however regard this kind of comment as a warning shot across the bows. I renew my call for researchers to deal in quality. Give the people who work on the ground with patients and populations, a robust and appropriate evidence base to work from. Moreover, as a discipline we must fight fire with fire. The quacks and the cranks are charismatic and they speak freely with no restraining issues (such as have to speak the truth). Where are the Brian Cox figures for our discipline? Who are the people who can ignite the imagination of the public and translate what is often a mundane message of uncertainty and caution, into the memorable and engaging?
Any volunteers? In the meantime I will desist from public brawling…