John Ioannidis Aims His Bazooka at Nutrition Science (2018)

1. There was a campaign against eating fats.

2. There was an obesity epidemic that started shortly after the campaign against eating fats.

Fact 2 is seductive because it’s natural to assume that 1) is the cause. But without further analysis and study one can’t conclude this. In a post decrying causal links without proper statistical evidence it’s ironic to fall victim to this seduction without proper statistical evidence.

Is there purity? No, not in the absolute sense. However, we're not some homogeneous mix either. Genetic, environmental and other such patterns do form a number different subgroups which while imperfect, remain useful.

The field was corrupted early on by the sugar lobby and it took an immense amount of effort to simply make it ok to admit saturated fats weren't bad for you again. Some 50 years of research negated by a deal that went down with a very small subset of people.

The Academy of Nutritionists and Dietetics is a complete and total waste of human effort. I've never encountered a more useless amalgamation of self-serving pretend professionals in one organization. Everything they do is to protect their organization and reduce entry. To even become a dietitian, after graduating from a didactic pathway you must do a 1-2 year paid internship. And by paid, I mean it costs you $20,000-$40,0000, you work 40+ hours a week, including unsupervised work, which makes the legality dubious, and in exchange you sometimes (but no always) get to take a few credits of useless grad level classes that won't get you any further to a master's degree. And then when you finally get certified, after an $80,000 degree and $40,000 internship, you get to start a job that pays about $55,000/year peak, assuming you aren't some world renowned specialist.

The people involved are just the worst. All play professionals who obsess over trivial details like professional attire and pointless faux psychology, like learning and motivational theory. They treat everyone like stupid children and design the absolute worst literature and outreach, catering to the lowest possible denominator with patronizing and condescending advice and horrible rap songs designed to get children to eat vegetables. Meanwhile this has left a vacuum of knowledge for anyone with two brain cells to rub together, and so any reasonably intelligent adult instead gets sucked in by even worse pseudo-science blogs, a phenomenon that was created and enabled by the Academy.

The kicker for me was when I took a community nutrition class that the majority of my classmates revealed that they believed in "health at every size" and that a registered dietitians primary function is respectful communication, (read: participating in the delusions of patients) not communicating important information and truths that could impact the patients health.

That's not even getting into the absolute sham that is most nutrition research and how much of it is funded by organizations who have a predetermined outcome and just need to find a way to fit the facts to what they want. Nutrition research is absolutely rampant with activist organizations trying to coopt the field to further their related agendas.

Controversially, I think we need to do less research. The publish-or-perish culture has created a perverse incentive to crank out junk papers. Most working scientists will privately admit that most research isn't actually advancing our understanding of nature, it's just a desperate effort to dredge up something sufficiently novel to publish. Conversely, there's a substantial amount of research that is potentially useful to clinicians, but is languishing unread in some third-tier journal. Most research is never published at all because it supports the null hypothesis, but we can't do good meta-analyses based on a cherry-picked set of studies. We're glutted with data, but we have a remarkable paucity of actionable information getting to the people who need it.

The problem isn't that scientists are doing a bad job, but that the funding mechanisms of science incentivise the wrong kind of work. We should be focusing a far larger proportion of our funding - perhaps even a majority - on replication, meta-analysis and dissemination. Primary research is only one small part of the information architecture of science, but it dominates our spending.

In the case of nutrition, we're spending huge amounts of money on figuring out whether coffee increases or decreases your life expectancy by a fraction of a percent, but almost nothing on behavioural research to figure out how to stop people from gorging themselves to death on food they know to be terrible for them. There's a morbidly obese elephant in the room, but we're preoccupied by the micronutrient-rich mice scuttling around the periphery.