“What is true at one time for us, at some point, no longer serves us and can eventually become a lie.” Carl Jung
I recently took an online certification class related to nutrition and brain health. The class was sponsored by an evidenced-based, national certification agency that is well respected in the health field. The information presented was backed by research from well-known scientists in the field of nutrition and neuroscience. Much of the course material focused on what we know about how certain foods are correlated with diminished or enhanced brain health as well as the role certain vitamins and minerals play as protective factors in cognitive decline. Until, that is, I got to the section about Ronald Reagan and jelly beans.
Most of the research in this course focused on dietary factors that had strong correlations with a person’s health status; most did not make any claims that certain foods caused any neurological disorders or age-related cognitive decline. Nutrition research is incredibly challenging; unless you lock someone up in a research lab for several months, it is impossible to control all the variables related to eating, and it is challenging to monitor the exact dose of the ingredient you are studying. Food journaling, a common way to collect nutrition research data, is notoriously subjective and lacks a high degree of confidence. Some innovative research techniques are being used to gather higher quality data, but what we know about how our food affects us is, as of now, only correlational.
It was surprising when, in the middle of the course, a Harvard trained physician presented an argument that the development of Alzheimer’s can be prevented with diets that are low in high fructose corn syrup. He supported his claim based on Ronald Reagan’s love of jelly beans, who started eating them in 1966 when he successfully quit pipe smoking. Reagan was obsessed with the candy; he ate so many of them that he put the brand Jelly Belly on the map during his presidency. He began to show evidence of memory loss during his second term in office and was formally diagnosed with Alzheimer’s in 1994.
This physician’s claim was not baseless--there is a volume of credible research that suggests diets high in processed foods, many of which use high fructose corn syrup, are associated with inflammation, which is associated with an increased risk of developing Alzheimer’s. It is reasonable that Reagan’s love of jellybeans may have been a factor in his eventual memory loss. But the science only suggests an association; the information was presented in such a way that it led one to believe that the Gipper’s cognitive decline was caused by eating jelly beans. The presentation lacked the measured language of science, which tends to be objective and measured, and presented evidence from only one study. There were many confounding factors that were not explored in this analysis: it lacked a discussion about environmental factors, the role of stress, childhood experiences, as well as the impact of a near fatal gunshot wound.
Not all research is created equal. In our digital era, health information spreads quickly through numerous sources, not all of which are credible. The internet provides access to journals and health resources, but many of us do not know how to read and interpret scientific data, nor are we skilled at evaluating the data to determine its reliability. And since research studies can be a dull read, we gravitate toward resources that give us snapshots of information, frequently without references to the important features of a study’s design. Importantly, many of us get a good deal of our health information from other people, typically those in our social circle or those we trust. Such a strategy is flawed, as it can be similar to playing the telephone game in which an original message is morphed as it is relayed through a chain of people.
How can we distinguish good health information from junk? If you have ever read any scientific articles or listened to researchers explain their findings, you will notice their lack of emotion and preference for noncommittal terminology. They use objective words such as “suggest”, “possible”, “association” -- language that lacks any enthusiasm and makes them seem as if they are unsure of themselves. We crave direction in our health information; we want the scientists to jump up on their desks, wave their hands in excitement, shout out their findings with confidence, imploring us to do this! But such is not the world of science. During the pandemic, Dr. Fauci was criticized and disliked by many because he spoke in the measured tone of science, not with the slick confidence of an influencer or a salesperson. We must remember that the truth rarely glitters; typically it is just off in a corner waiting for us to notice.
Good science mirrors what many spiritual and philosophical traditions tell us about the pursuit of the truth: it requires diligence and a relentless commitment to having our beliefs proved to be wrong. Pursuing the truth is an act of courage, one in which we are always open to having the rug pulled out from under our feet. The scientific method reflects this foundational approach to the truth, tasking a researcher with doing everything possible to prove that a hypothesis is wrong. Good research is designed to disprove what we think is right—not confirm it but to find evidence that will debunk any and all assumptions. And similar to the guidance of some wisdom traditions, the scientific method does not cling to absolutes; even when there is sufficient evidence to support a hypothesis, as there is always a chance that what is true at one moment in our lives will, at some future point, become untrue.
Studies on how we make choices confirm that we are not the rational decision makers we believe ourselves to be. Very few of us follow the detached path of scientific investigation. Rather than try to disprove what we think is true, our tendency is to seek information that supports our beliefs. This is especially true for health choices, which are deeply rooted in our subjective experiences, histories, culture, social circles, and health beliefs. These subjective factors are arranged in a sort of playbook we reference when seeking out health information. We think we are searching for the truth when we are actually looking for material that will confirm our beliefs, a phenomenon known as confirmation bias. It is rooted in a genuine desire to discover the truth but in practice is a targeted search for information that resonates with our beliefs. Confirmation bias runs deep; people tend to stick to their health beliefs even when they are presented with conflicting data. This bias can be so strong that we take new information and skew it so that it fits into our original belief; this explains the contradictory health decisions we make, such as the smoker who eats a strict vegetarian diet to protect against getting cancer, or the self-proclaimed junk food addict who exercises every day.
In a world in which we are overloaded with health information, confirmation bias helps us process and sort through the endless array of data, studies, and advice that is at our fingertips. Information that supports our beliefs offers a sense of stability and reinforces our ideas of who we are. And choices about our health can be stressful; we experience a great deal of friction when we are required to consider information that contradicts our beliefs. Confirmation bias lowers the risk of feeling negative emotions.
When it comes to making health related decisions, we tend to prefer simple solutions. Changing behavior is hard—it is disruptive, creates some level of stress, and can be exhausting. Simplicity offers a sense of stability and helps build our confidence. But our proclivity for binary, “do this, not that” solutions is what makes us vulnerable to misleading health information. Health and wellness is no longer the exclusive territory of health care professionals. In the past twenty years it has grown into a multi-billion-dollar industry that uses sleek advertising to promote services and products, with a wide array of physician backed specialized programs that hold the promise of curing diseases, reducing symptoms, or slowing their progression. Some of these products and programs are based on scientific principles; others play with our desire for simple solutions. When it comes to our health, we are wise to lean toward the truth, however difficult that may be.
Did jelly beans cause Reagan’s Alzheimer’s? It could be that one day we’ll find that to be true. But for now, the one research study I read that specifically tested high fructose corn syrup was not convincing, nor was it published in a journal that conducted a rigorous peer review. And the author’s summary was heavy on the reasons why the hypothesis was right while light on reasons it could be wrong—a far cry from the fearless commitment to the pursuit of truth required of the scientific method.
Over the next several weeks, we’ll explore specific health beliefs through the sharp lens of the scientific method, asking, “Is this true?” and “How do I know this is true?”. We won’t dig through dry data but seek to rock the foundation of what we believe to be true about nutrition, exercise, physical activity, sleep, and stress. Some of what we explore may create some tension as it challenges your beliefs. The goal is not to change your mind or skew you in a particular direction. Rather, my hope is that this information generates some discomfort, a bit of friction that spurs you to examine the ground you stand on, creating more questions than answers. Let’s start the summer with a soft heart and a willingness to lose our balance, allowing cracks to form in our foundation, providing opportunities to rebuild so that we can fall apart again.
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