The ‘Nutritional Awakening’ of the 1980s Created a Lot of Confusion

It was the decade of damned if you do, damned if you don’t.

Decaffeinated coffee won’t give you the jitters, but it may raise cholesterol.

Calcium prevents osteoporosis? Depends on whom you ask.

Fish high in omega-3 fatty acids may reduce heart disease. Fish high in omega-3 fatty acids may contain carcinogenic chemical contaminants.

Beef has saturated fat, which is bad. Beef has a kind of saturated fat that may be good.

Eat fewer eggs. Eat more eggs.

Cruciferous fruits and vegetables decrease the risk of cancer. Pesticide-laden fruits and vegetables increase the risk of cancer.

Beef gives you strength. Chicken gives you salmonella.

“After a while, when people get bombarded with so many messages, they just stop paying attention. It’s like going into a store and there are 75 shirts and you end up buying nothing,” says John C. LaRosa, dean for clinical affairs at the George Washington University Medical Center.

The 1980s were historic years for studies and news about the connection between diet and disease. “Reduce cholesterol” became the masses’ mantra.

“Everyone is taking food much more seriously,” says Nancy Wellman, president of the American Dietetic Assn. “We’re much more sophisticated in expecting our food supply to be healthier.”

“Clearly there’s been a nutritional awakening. I haven’t felt as much at risk giving the message as I used to. It’s not considered heretical,” says Johanna Dwyer, director of the nutrition clinic at the New England Medical Center Hospital and professor at Tufts Medical School.

At the same time, nutritional concerns (fat, cholesterol) were joined by food-safety issues (pesticides) -- and everyone was left trying to rationalize the two. Individual foods simultaneously became both good and bad, safe and unsafe, a concept that the public had a hard time understanding.

When it comes to the food risks of the ‘80s, says Peter Sandman, director of the Environmental Communication Research program at Rutgers University, “the first (nutrition) is much more serious. The second (food safety) is much more outrageous.”

Sandman believes that the second wave of food concerns was fueled by resistance to the first. “People would rather focus on a risk that is not their fault rather than (on) one that is their responsibility,” he says. There has been a remarkable change in people’s diets as a result of the first risk, continues Sandman. “But they hate it. People don’t like thinking, ‘that pure wonderful ice cream is killing me.’ They would much rather think that EPA and Uniroyal are killing me. It is much more satisfying to be angry than guilty.”

As for which emotion makes people change their eating habits, Sandman acknowledged that “millions of people have cut down on cholesterol,” but that angry people don’t always change their behavior.

As the public of the ‘80s seesawed between angry and guilty, the science seemed to seesaw from one finding to a contradictory one. While many people viewed the back and forth as a sign of chaos, scientists were grappling with how to explain the course of progress.

“In science we very seldom have the final answer. As we learn more, we have to change our answer, or at least limit it or widen it,” says Nancy Ernst, nutrition coordinator for the National Institute of Health’s National Heart, Lung and Blood Institute.

What’s more, single studies don’t make for the be-all, end-all conclusion. They “should be a word,” Ernst said. Often, they’re a call for more research, she said.

The public, however, wants to know “if they start or stop eating one particular food that it will guarantee better health,” said Wellman. Unfortunately, scientific studies aren’t necessarily designed to reach that end, and foods are composed of numerous nutrients that perform a whole host of functions.

What complicates things is the process by which findings are communicated. “The system is set up in such a way that the seesaw is exaggerated,” said Sandman. “Information that opposes prior information gets more attention than the status quo. Scientists advance their reputation more if they come up with something new and surprising rather than old and established. Scientific journals are more apt to publish those findings. The media does the same thing.”

Indeed, the way medical information is marketed has been cited as a classic reason why dietary findings can get distorted or misinterpreted.

For example, the press gets its copy of the New England Journal of Medicine before LaRosa does and sometimes he is asked to comment on a study before he has seen the article. “We fortunately and unfortunately have instant communication from the scientific journal to the public, bypassing any filtration from experts who might want to put it in perspective,” he said.

LaRosa also believes that the flashy, dramatic studies will always be the ones to get media coverage, often at the cost of more important scientific advances.

The most significant news at the recent American Heart Assn. conference was not the study that decaffeinated coffee may raise blood cholesterol, LaRosa said, but three studies that showed regression in humans of coronary atherosclerosis (two with drugs, one with diet plus other life style changes). The coffee study, which has not been peer reviewed by other scientists, is only a single study that is clinically marginal, he said.

Part of the problem is that by their very nature the media and science are often at odds. Most scientists are cautious about drawing conclusions and talk in careful and hedged terms. In the media, short, definitive statements are the most convincing; the scientist who comes across best is the one who looks certain, said LaRosa. “I almost always lose debates with zealots,” he said. “ ‘It might be this, it might be that’ is harder to quote.”

Dwyer believes it’s not necessarily the media’s fault, that some scientists are better than others at promoting themselves. “All of us love our work. It’s difficult not to gallop forward, especially if you think you have the cure to mankind’s ills,” she said.

There is also a difference between scientific progress and scientific silliness, she said. “The latest study isn’t necessarily the best study. The scientific silliness is that the latest must be the best. It’s not true.”