Finding Common Ground for Nutrition in a World of Alternative Facts

by Rachel Baer

Rachel Baer tackles the implications of the “post-truth” culture for the nutrition profession and poses 3 questions to consider about our response to the unending barrage of nutrition-related “alternative facts.”

As a registered dietitian, I can tell you this: Nutrition professionals know a thing or two about alternative facts. We spend our careers with textbooks and scientific journals in hand, waiting for the next misinformed food fad to go viral. We fight to defend the facts because we have always believed that if we could show people what is true, we could convince them that we have the best answers for their nutrition-related questions. But the concept of truth is losing popularity.

The Oxford English Dictionary declared the term “post-truth” to be the 2016 word-of-the-year. Post-truth is defined as “related to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief.” Let that sink in for a moment: emotional appeals are more influential than objective facts. While this concept is alarming on many levels, I am particularly concerned about its implications for health professionals who rely on scientific truths as the basis of their credibility.

Don’t get me wrong. I understand the frustration people feel as they watch seemingly contradictory nutrition headlines emerge at the very hint of new research findings. One day people are told to limit egg consumption to 3 yolks per week, the next, the one-yolk-per-day allowance is back. However, as nutrition professionals, we have a certain appreciation for the fact that science is ever-evolving. We hold our recommendations lightly because we believe in a scientific community that is always growing, and that new discoveries only sharpen our understanding of nutrition and physiology. The public, on the other hand, does not always share this appreciation.

Confusion over wavering nutrition claims is exacerbated by the inundation of un-credentialed, unschooled voices clamoring for attention in popular media. Social media has provided a proverbial soapbox for anyone with a passionate message to share, regardless of qualifications. Simultaneously, dietitians tend to hold back on making bold retorts, often waiting for consensus to catch up with the fads so that our recommendations are supported with the latest research. This seeming imbalance of voices alongside the emergence of the post-truth culture only perpetuates the proliferation of unfounded claims, or “alternative facts,” as they have become popularly known.

I have no easy answers for this predicament, but here are 3 questions that we could benefit from exploring as nutrition professionals:

1. How do we remain experts while also being compelling?

Dietitians have long been referred to as the “food police.” While I resent this reputation, it highlights a worthy question: Do nutrition professionals present information in a way that is relatable, realistic, and winsome to the people whose respect we want to gain?

We can no longer depend solely on the letters after our names to gain an audience with the public, particularly when we are pitted against wayward blog and media influencers using sensationalized language to win over vast groups of people who blindly follow their passionate advice. The internet is full of examples of people preferring to follow the advice of a persuasive friend or influencer over the advice of a knowing professional. While this situation is endlessly frustrating to those of us who see through their hyperbolic messages, is there anything we can learn from these blog/media personalities that may help us reach the audience they seem to have hooked? How do we successfully build rapport with the public while maintaining good science?

2. How do we talk about fundamentals in a world that wants controversy?

Let’s face it. Fundamentals don’t make great headlines. For decades, consensus research has revealed that a diet full of minimally-processed fruits, vegetables, whole grains, nuts/seeds, lean proteins, and healthy fats is unequivocally and unanimously the best diet for human health. Yet, people still search elsewhere looking for the latest and greatest weight-loss, risk-reducing, and health-enhancing diets. Could it be that balance is more challenging than we thought? Perhaps avoiding certain food groups or food ingredients altogether is easier than the amorphous concept of moderation? Our greatest challenge is not getting more people to consume health information, it is finding new and compelling ways to deliver the information we’ve known for decades, and this is no small task.

3. How do we overcome differences within the nutrition profession to present a united front to people lost in the sea of alternative facts?

In 2014, David Katz and Walter Willet co-chaired a conference sponsored by the non-profit Oldways*, titled “Finding Common Ground.” Oldways and the co-chairs assembled what they referred to as “the dream team of nutrition experts,” including Friedman’s own, Dariush Mozaffarian, as well as Dean Ornish, creator of the Ornish Diet; David Jenkins, founder of the glycemic index; Boyd Eaton, originator of the Paleolithic diet; Collin Campbell, author of The China Study; and a myriad of others. Known most commonly for their differences, this group of scientists gathered together for the sole purpose of coming to a consensus on the basic tenants of a healthy diet. In the end, the group agreed on 11 common denominators of the widely differing philosophies they espouse. The topics ranged from fruit and vegetable consumption, to sustainability, to food literacy.

Following the conference, David Katz published an article in Forbes where he said “…it is the controversies at the edge of what we know that interest experts most, but ask [experts] about the fundamentals, and the vast expanse of common ground is suddenly revealed.” The Common Ground committee’s decision to gather around a table, invite open dialogue, and pursue unity is something we could all learn a lesson from. Alternative facts will always provide fodder for hucksters and peddlers of over-simplified nutrition information, but the scientific community has a vast body of research that unites us. As nutrition professionals, we cannot forget that our voices will always be more powerful together than they ever will apart.

Rachel Baer is a registered dietitian and a first-year in the NICBC program at Friedman. Her favorite foods are Brussels sprouts and brownies, and she loves nothing more than cooking great meals and gathering people around a table.

*Editor’s Note, 5/1/17  2:09 PM: An earlier version of this article incorrectly spelled the name of the organization, “OldWays.” The correct spelling is Oldways, and the change has been made above.

A Crash Course in Informational Interviewing

by Kathleen Nay

For someone new to networking, the process can seem intimidating and unclear as to where to begin. Informational interviews are a low-risk but valuable way to start building a professional network.

If you had asked me a year ago what an informational interview was, my likely response would have been, “Informational interview? What’s that?” It was a term I’d never heard before, but it piqued my interest. I knew “networking” was a thing “professionals” did, but to someone like me—new to grad school, new to my understanding of how public policy works, and new to Boston where I didn’t know anyone—networking sounded like a vague and intimidating process. I knew it was an important skill to develop, but wasn’t sure where or how to start. Informational interviewing, I’ve learned since then, is an easy, concrete way to begin building your professional network and hone your career path goals.

First, what is an informational interview? An informational interview is exactly what it sounds like: while similar to a job interview, it is less about trying to sell yourself and more about exploring the landscape of organizations or careers you might like to pursue. It is not about asking for a job—though it could lead to one down the line—but rather a chance for you to ask questions of experienced professionals in your field to help you evaluate your own skills and interests. Typically 20-30 minutes long (but often longer), they are meant to be conversational, low-risk meetings where you get to set the agenda.

They’re not just for networking. People participate in informational interviews for a host of reasons. As a new grad student, you might be curious about what classes other alumni from your program found most valuable, or what skills they wish they’d learned before entering the job market. You might want to find out how they like their job to see if it’s something you want to do. If you’re about to enter the job market, informational interviews are a useful way to learn about work sites, career tracks within a sector or company, or about specific roles. Even for working professionals who have established careers, informational interviews are valuable for expanding the breadth of one’s knowledge about a field, as well as for exploring the edges where one field meets another.

What kinds of questions should I ask? Before engaging in an informational interview, know your objectives. What do you want to learn about this person or company? Remember—you’re the one setting the agenda, so be prepared with a list of questions to guide the conversation.

If you’re most interested in the person’s career path or their field generally:

  • What’s your story? How did you get here?
  • Where do you see your industry heading in the next 5-10 years?
  • Are there any skills you recommend I master while I’m still in school? Classes I should take?
  • What are you hoping a next generation player like myself will bring to the table to further this work?

If you want to find out about a particular job, organization, or work culture:

  • What do you like most about your job? What don’t you like?
  • What does a typical day look like for you?
  • What is work-life balance like at your company? Does your organization offer continuing education opportunities? What is the expected starting pay for someone with my degree? What is the work environment like?
  • What specific skills are necessary to succeed at your company?

Remember to let the conversation guide you. If something they say sparks a question you hadn’t thought of before, ask it! For example, if they mention that they moved from the public to private sector, ask about that transition and what prompted their decision. If they mention collaboration with a partner organization, ask about that partnership. Be genuine and express interest in whatever they say. Even if it’s something you find less than compelling or don’t agree with, it can still inform your career decisions.

Okay, so how do I identify someone to interview? Alumni networks are a great place to start. Friedman’s alumni network is 1,700 people strong, and it’s easy to get connected with the Alumni Association on LinkedIn or Facebook. The Tufts Online Community is another excellent resource for searching among more than 100,000 Tufts alumni by region or interest areas. Friedman’s Student Affairs office keeps binders of internships completed by past students, including their contact information. It’s as easy as asking that alum for an introduction to someone at the organization you’re curious about. Additionally, our professors are well connected—if there’s a specific organization they’ve mentioned or a guest lecturer they’ve had in class, ask your professor if he or she can connect you.

There are less obvious ways to go about finding people to interview, too—like literature searches. Who’s an expert in the field? Who has written articles that resonate with you? Often their contact information is included in the article—send an email expressing your interest and a couple of questions you have. Planning to attend any upcoming conferences or events? People love to hand out their business cards, and having already met someone gives you a great excuse to follow up with a request to learn more about each other over coffee. You might even find someone’s contact information on a website and decide to reach out.

At each interview you do, conclude by asking whom else you should know. Your interviewee will likely be able to identify other professionals with similar interests, and may even offer to introduce you. Take them up on their offer—this is a key component to network building!

What else should I know? Basic interviewing etiquette applies. Keep your correspondence professional. Research your interviewee beforehand. Dress presentably. Take notes. Remember to follow up with a thank you email or, even better, a hand-written card.

But here’s the most important piece of advice: stop talking. Even though you asked for the meeting—even though you’ve set the agenda—an informational interview is not about you. Most people love to talk about themselves. Let them! Your role is to learn from their experiences and be receptive to their advice.

Finally, relax. Informational interviewing sounds scary and formal, but when it comes right down to it, it’s just a conversation. You’ll learn as you go, and it will get easier every time. Remember that people who say “yes” to you will be thrilled to share, because they were once in your shoes. Just be your authentic self! You’ll come away not only knowing more about your field, but with new directives for your career. And if you’re lucky, you’ll collect a network of professional mentors who want to help you succeed.

Kathleen Nay is a second-year AFE/UEP dual degree student who found her internship quite by accident through an informational interview, and has met some inspiring people by doing more since!

 

Health Literacy 101: How You Write Matters!

by Ally Gallop, RD, CDE and Claire Whitney, RD, LD

Health literacy. Ever heard of it? Well, there’s a 99.9% chance you’ll stumble upon it in your future career. You will need health literacy if you want a population or an individual to comply with your suggestions, be it to eat more vegetables or exercise daily. Over the winter break, Tufts University’s Public Health and Professional Degree professor Sabrina Kurtz-Rossi led an eye-opening course in health literacy (HCOM 509). We were shocked by our carelessness! So where are we, as future communicators, going wrong?

At Friedman, students tend to have the freedom to select a topic for an assignment or paper. We conduct the research and revise multiple drafts, and after a final self-edit, an end product is produced. Often, these papers are intended for our professors or other health professionals. Beyond the classroom, writers for the Friedman Sprout select a topic of interest, peer-edit, and unleash the finished articles to the world.

However, some of these and future projects require writing for children or the general public, groups that require a shift in writing style and word choice. After making any appropriate edits we default to Microsoft Office to verify our changes with its readability option. Readability considers the number of words in each sentence and the number of syllables each word contains. Based on this assessment, a grade level is assigned.

But then what? Do we ever consider the impact of our message on our target audience? Do we accept an eighth grade reading level as being easy to read from the perspective of that audience? Aren’t we as health communicators forgetting something?

Left out of the readability formula is health literacy. Health literacy is not only a person’s ability to read, but it also considers

  • Layout and formatting of the text
  • Words chosen when verbally communicating health messages
  • Inclusion of technology (e.g., the internet)
  • Learning ability of an individual
  • Cultural appropriateness

Together, these factors clarify messages being delivered by health providers. Purity in message delivery increases one’s ability in making informed decisions about their health.

How do people find and process health information?

The flow chart below presents the Calgary Charter on Health Literacy’s logic model that follows how an individual finds information and puts it into action. When providing health information as a communicator, a break in the chain is a break in your ability to deliver a message and implement behavior change.

Screen Shot 2016-01-30 at 5.11.04 PM

Revised from The Calgary Charter as a framework for health literacy curriculum development and evaluation. Presented by Andrew Pleasant at the 2013 IHA Health Literacy Conference in Irvine, CA. May 2013.

Major takeaways from HCOM 509 for nutrition communication writers

In relation to written communication, the key concepts learned from Professor Kurtz-Rossi’s class include:

  1. Assume that everyone is health illiterate

Why does health literacy even matter? Lacking health literacy is linked to poor health outcomes and knowledge about health, increased medication errors and health care costs, and under-utilization of health care services. Individuals often hide reading, writing, and comprehension difficulties, which makes it hard for communicators to assess whether their messages have gotten through.

The Program for the International Assessment of Adult Competencies 2012 (PIAAC) measured the literacy (which it defines as “understanding, evaluating, using and engaging with written text to participate in society, to achieve one’s goals and to develop one’s knowledge and potential”), numeracy, and problem solving in technology-rich environments among American adults. PIAAC found that only 12 percent of those aged 16 to 65 years met the highest literacy score, which is significantly below the international average. Another measurement by the U.S. Department of Education reports that 9 out of 10 American adults have less than proficient health literacy scores.

It does not matter if your intended audience is lawyers, athletes, or even those with a science degree; you cannot assume that they understand health and medical messaging.

Solution: No matter how educated your audience is, assume they lack health literacy. Speak and write in plain language by defining essential medical words and replacing jargon with living room language. This is not condescending; it is respecting the individual receiving the message.

  1. Readability formulas are not the gold standard

Readability formulas, like Microsoft Office’s Flesch-Kincaid Grade Level, do not measure health literacy. Formulas may still be used, but not in isolation. A similar comparison is only using body mass index (BMI) in determining a patient’s health—even though it only considers height and body weight. Although BMI is one measurement tool it should be used in concert with others (e.g., blood cholesterol panel, waist circumference, a patient’s self-evaluation, etc.).

Measuring your writing’s readability should also be applied to blogs, emails, and any other technological means. Combing through blogs by dietitians, we found an average reading level of grade 10!

Solution: You could still use readability formulas as a starting point, but try supplementing those scores by evaluating the writing’s layout, spacing, and format. Other options you may want to try out include the Fry Readability Formula.

  1. Gain input from your target audience. And then ask for feedback again and again and…

When first setting out to write, how often do you think about the target audience? Do you consider their age or socioeconomic status? Do you evaluate what they want to know about the topic?

Although you may have a peer or an editor review your work, remember that they are likely not your target audience. Your article means nothing if your audience cannot understand it and use the information. Reaching out to intended readers at the beginning, during draft writing, and in finalizing the piece are vital in ensuring that your writing is relevant.

Solution: From topic selection to the final copy you need to gain feedback from your target audience. This includes what valuable information is included (i.e., the “need to knows”), the article’s format (e.g., dense text, bulleted lists, images, and article length), and if the delivery of the message persuades one to change a behavior.

Going forward

When writing for the public, stop wasting your time writing an article that interests only you. Think about the audience you are writing for and how well they understand and interpret your message. As health communicators, if people are going to take the time to read your work then ensure they are able to understand and implement it.

Ally Gallop, RD, CDE is a second-year nutrition communication and behavior change student focusing in U.S. food and nutrition policy. She now uses readability formulas solely as a starting point.

Claire C. Whitney, RD, LDN is a second-year nutrition communication and behavior change student with an interest in Food Business and Communication. Being dyslexic, she understands first-hand the importance of plain language and readability.