Being Evidence-Based

Being Evidence-BasedThe field of health and nutrition is filled with buzzwords. Some of them, like diets, come and go; while others are more eternal.

One buzzword I’ve seen a lot of over the last couple of years is “evidence-based” or “science-based”. It’s something that many practitioners claim to be.

The basic idea this term is meant to convey is that this practitioner does their research and looks into the science before making any claims. Or that when making a statement, they can back it up with some study or collection of studies.

It’s meant to distance themselves from the “wellness” crowd, who make outlandish claims about “toxins” or “juicing” or “sugar” that aren’t backed by science.

Now I like the idea of being evidence-based. I put myself in this category, so I don’t think it’s a bad thing. But there are a couple things to keep in mind.

Often someone being “evidence-based” means that they just tell you to follow the government guidelines. That if the NHS, FDA, or the WHO recommends it, then you should follow this advice.

While I don’t totally disagree with this, it surely has its limitations. When you’re making recommendations for the population of a whole country or the whole world, these recommendations are going to be very generic. You can’t get too specific because whatever you say has to be accessible or appropriate for everyone (or at least everyone within a specific category that is being commented on, e.g. pregnant women or adolescents).

So knowing these general guideline recommendations may be a good starting place for a practitioner. But it’s probably not enough if you’re wanting something tailored to your specific needs and requirements.

For other people, being “evidence-based” isn’t as unbiased as the name would suggest. In reality, they start with a belief in mind, they do some “research” to find studies that support their belief and that’s the end of that. They then feel justified in telling people to go paleo or low carb or to avoid all cardio because of “science”.

Now I will admit that this stuff isn’t easy. There are mountains of scientific papers for nearly anything you’d ever want to look into. So there is a lot to wade through.

But even when just looking at one paper, it’s not so straightforward.

It’s amazing how people can come to many different conclusions about one single study. So you have the “saturated fat is good” crowd using a particular study and saying how it proves their point. You then have the “saturated fat is bad” crowd using the exact same study to show how it proves their point.

What I’ve noticed is that the more I study, the more I see how grey things really are. And when I see someone being inflexible in their beliefs about something being the one true way, the more I’m suspicious of how “evidence-based” someone really is.

But as a practitioner, there’s something else to be aware of. Which is this: being evidence-based should be a starting place, not the end goal.

When looking into what the science says on a particular topic, you’ll only learn the averages for those people who were part of that study.

So for example, if a study looks at the results of people eating more blueberries, it’s just explaining what happened for those people who participated in the study.

Now this is a very good entry point. But with the particular client I’m working with, they could be like the average, but they may not. They could get much better results than what the study would have predicted, they could see no improvement, or it could make things worse.

A real life client is not a statistic. Just because some study or collection of studies said something is a good idea doesn’t guarantee that it will work for that individual.

And this is a skill I’ve developed over years of working with clients. Typically you can’t “book-smart” your way to really understanding this, it takes time.

Just because someone is a researcher or knows the science, doesn’t necessarily mean they will be a good practitioner. People are complex, irrational, and are impacted way more by environmental factors and previous life experiences than the meritocracy narrative would have us believe (You know, that idea that if you’re dedicated and work hard, you can have anything you desire).

Being a successful practitioner is about taking evidence-based information and making it relatable to the client, while figuring out how they can incorporate this into their life (and determining which bits actually works for them).

Most people couldn’t care less about the p value of some study on blueberries; they just want to improve their health.

As part of this, we shouldn’t underestimate the value of experience and what someone has learned through working with clients.

There are plenty of things that I’ve seen happen over and over again in practice, despite having no scientific explanation for why they happen. Maybe at some point the science will be able to explain it, but prior to this happening, I can still talk about this with clients and ensure them it’s normal or that I’ve seen it before and it’s a common part of recovery.

Nutrition, as a science, is in its infancy. Now, this shouldn’t mean that people can claim anything they want because who’s to say it isn’t true. But equally the jury is still out on much of this stuff and we have to admit the current limitations.

But even if we fast-forward 50 or 100 years, when we have a better understanding of the science, there is still going to be a lot of murkiness. And this is due to the individual differences of each person, as well as the almost infinite number of factors that impact health and physiology (because it’s not just about food).

I’m completely in favour of practitioners being evidence-based. But, like everything else, it’s about how this fits into the context of what they are doing. And just shouting, “I’m evidence-based” doesn’t necessarily tell you much about someone’s ability as a practitioner.



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Chris Sandel is the founder of www.seven-health.com. He is a nutritionist, working with clients on a one-on-one basis, as well as creating online trainings and products about health and nutrition. He is the author of The Health Trap: Why "Healthy" Eating Isn't Always Healthy which is available on Amazon UK and Amazon USA.

Chris has three free emails series. One is on how to quit dieting. One is on simple tests you can do at home. And the other is his take on the world's healthiest foods.

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