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Why is nutrition so hard to study?

Why is nutrition science so complicated?

Why is nutrition science so complicated?

There are a few things that make nutrition a tough nut to crack, scientifically speaking. For example, because we all eat a variety of foods, it’s hard for researchers to parse the body’s response to one specific food the way they could with a medication.

Why is nutrition so hard to study?

Nutrition is wrapped in multiple confusions. Why is it so hard to determine whether a food is good or bad for health?

In medical science, proving any theory is difficult. The science of nutrition is no different, but it also has some unique challenges. In this feature, we outline just some of these stumbling blocks.

Despite the many issues that nutrition scientists face, understanding which foods benefit or harm health is essential work.

Also, the public is growing increasingly interested in finding ways to boost health through diet. Obesity and diabetes are now highly prevalent, and both have nutritional risk factors. This has sharpened general interest further.

All areas of scientific research face the following issues to a greater or lesser degree, but because nutrition is so high on people’s agenda, the problems appear magnified.

A changing world

Although the water is muddy and difficult to traverse, there have been substantial victories in the field of nutrition research. For instance, scientists have determined that vitamin C prevents scurvyTrusted Source, that beriberiTrusted Source develops due to a thiamine deficiency, and that vitamin D deficiency causes ricketsTrusted Source.

In all of these cases, there is a link between a particular compound and a specific condition. However, the picture is rarely so clear-cut. This is especially true when investigating conditions wherein multiple factors are at play, such as obesity, osteoporosis, diabetes, or heart disease.

Also, nutrition-related conditions have changed over time: The most common threats to health used to be deficiencies, whereas in Western countries today, overeating tends to be the primary concern.

Understanding the role of food in health and disease is essential and deserves attention. In this feature, we discuss some of the reasons that nutrition research seems to be so indecisive, difficult, and downright confusing.

The ‘perfect’ nutritional study

In an ideal world, to understand the health impact of a given food — goji berries, for instance — an experiment would go something like this:

Scientists recruit 10,000 participants (both males and females, from a range of nationalities and ethnicities) and house them in a laboratory for 10 years. The scientists feed each person the exact same diet for the duration of their stay, with one difference: Half of the participants consume goji berries surreptitiously — perhaps blended into a mixed fruit smoothie.

Alcohol and tobacco are banned for the duration of the study.

The participants must also exercise for the same amount of time each day; if some people exercised more, they might become healthier, regardless of their goji berry intake. This would skew the data.

Neither the researchers nor the participants are aware of who is receiving the goji berry smoothie; if the participants knew they were receiving a “superfood,” they might benefit from the placebo effect. This so-called double-blinding is vital when running clinical trials.

During the decade-long study, the scientists monitor the participants’ health intensively. This might involve running regular blood tests and medical imaging.

Of course, the astronomical cost of this type of study is the very first stumbling block. Also, ethics and good sense say that this is beyond impossible.

In lieu of perfection

Nutritional research has to make some concessions, as the perfect study is unachievable. So, in “observational studies,” nutrition scientists look for links between what a person consumes and their current or future state of health.

Observational studies can be incredibly useful. Using this method, scientists proved that tobacco causes lung cancer and that exercise is good for us.

However, these studies are far from perfect.

One issue with observational studies is the researchers’ reliance on self-reported food intake. They ask participants to note down everything they eat for a set amount of time, or to remember what they ate in the past. This could refer to yesterday or months earlier.

However, human recall is far from perfect. Also, some people might purposely miss certain food items, such as their third candy bar of the day. In addition, participants do not always know the exact size of their portions, or the full list of ingredients in restaurant or take-out foods, for instance.

Studies often ask questions about the long-term impact of a nutritional component on health. However, researchers tend to take dietary information at just one or two points in time. In reality, people’s diets can change substantially over the course of a decade.

The role of industry

These issues prompted a highly critical study, which appeared in the journal PLOS OneTrusted Source, to pull apart data from the National Health and Nutrition Examination Survey (NHANESTrusted Source).

The NHANES, which began in the 1960s, “is a program of studies designed to assess the health and nutritional status of adults and children in the United States.” Experts use the findings to guide public health policy in the U.S.

The primary method of data collection for the NHANES are 24-hour dietary recall interviews. Researchers use this information to calculate energy intake.

The authors of the critical paper conclude that “the ability to estimate population trends in caloric intake and generate empirically supported public policy relevant to diet-health relationships from U.S. nutritional surveillance is extremely limited.”

In an opinion piece, lead author Edward Archer pulls no punches, explaining that their paper demonstrated “that about 40 years and many millions of dollars of U.S. nutritional surveillance data were fatally flawed. In […] nutrition epidemiology […], these results are commonplace.”

Here, we meet the double-edged sword of industry: The PLOS One paper declares that funding for the critical study “was provided by an unrestricted research grant from The Coca-Cola Company.”

Industry funding certainly does not invalidate the findings of studies, but it should prompt us to wonder what the funder might gain from such research. In this case, a company that produces sugary drinks might benefit from destabilizing people’s faith in the research that has deemed their products unhealthful.

Perhaps this example is a little unusual; more commonly, an industry with a vested interest will fund studies that demonstrate the benefits of a product.

For more on this topic, read our article on the sugar industry and how it manipulated scientific discourse in its favor.

To reiterate, if a study secures industry funding, it does not mean that people should dismiss the findings out of hand. However, it should provide food for thought.

Another study in the journal PLOS Medicine looked at the impact of industry funding of research into soft drinks, juice, and milk.

The authors conclude, “Industry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors’ products, with potentially significant implications for public health.”

To add to the confusion, media outlets tend to amplify these findings. If, for instance, a study funded by a chocolate manufacturer concludes that chocolate extends life, media outlets will faithfully reproduce the conclusions, often without a mention of the funders or a discussion of the study’s limitations.

Diving into complexity

Another issue that seems to plague nutrition research is complexity. Sometimes, a study will focus on the impact of just one specific food item or compound on a health outcome. This is slightly easier to manage.

Often, however, studies will try to investigate the impact of a particular diet. The Mediterranean diet, for instance, has gained a lot of attention over recent years.

The difficulty here is that one person’s version of the Mediterranean diet could be very different from another person’s version. For instance, one person might have one small glass of red wine, 25 olives, and an artichoke each day, while someone else — who may be in the same experimental group of a study — might drink no wine and eat neither olives nor artichokes.

A related issue is that of replacement: If someone eats no meat, for instance, they are likely to replace meat with other sources of protein, such as beans or pulses. So, when comparing diets that contain meat with those that do not, any health effects might not be due to the lack of meat but the addition of other foods.

Every type of fruit and vegetable contains a vast array of compounds, and the type and amount of these can vary depending on where they grow, how people transport and store them, and how they process and cookTrusted Source them.

There are so many variables to take into account that even when a study does find a statistically significant result, it is difficult to determine if it actually came from the food under investigation.

Of course, humans are just as diverse as the foods they consume. Eating a single peanut might provide one person with beneficial nutrients, while that same peanut could be fatal for someone with an allergy.

One 2015 study makes the same point but in a more subtle way. The scientists continuously measured 800 participants’ blood glucose levels and found “high variability in the response to identical meals.”

The authors explain that this suggests “that universal dietary recommendations may have limited utility.”

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