Dietitians use evidence based nutrition to guide their clinical decision making. This means that they are utilizing the most updated research in deciding how to best treat patients, and to know which information is the most helpful when educating their clients. This means that the treatments and education you receive will be based on scientific studies that are current. This is desirable because it means there is evidence that the recommendations are effective. Additionally, it means that the information is current as opposed to outdated.
Research and Evidence Based Nutrition
Dietitians and other scientists conduct research studies and experiments. Analytical skills are used to figure out what outcomes are significant and which ones need to be studied further. Over time, research is used to decide what changes to health care practice should be implemented.
There are different types of research studies. Here is a list of studies that are commonly used to update nutrition guidelines or recommendations:
- Randomized controlled trials- these studies compare outcomes for different groups of people, one group receives a treatment that is being studied and the other group does not receive the treatment. These studies will often be double blinded, where both the participants and the researchers do not know who is receiving the treatment and who is not. These kinds of studies are best for showing cause and effect.
- Cohort studies- information from specific groups of people is studied to find common factors and outcomes among them. Studies can be prospective or retrospective.
- Case control studies- these studies compare individuals who have an outcome of interest such as a chronic illness, to those who do not have the illness.
- Cross sectional studies- these are surveys used to gather information from a specific group of people.
- Case reports- this is a study of an individual with a unique medical event or outcome.
- Qualitative studies- in this kind of study, researchers look at participants’ thoughts and observations.
Research studies or papers are often published in medical or food and nutrition journals. Several examples of journals that include nutrition studies are the Journal of the Academy of Nutrition and Dietetics, Journal of Parenteral and Enteral Nutrition, Nutrition in Clinical Practice, American Society for Nutrition, and the Journal of Nutrition.
When New Research is Implemented into Practice
Typically, changes to clinical practice are made when scientists can show the same and consistent outcomes over and over again. This is done with a systematic review. Researchers who write systematic reviews may create a summary of many studies they collect on the topic they are researching. A systematic review may also be made by combining data and/or outcomes from many randomized controlled trials; this is called a meta analysis.
We do not want to make changes to medical care based on just one study. I find it concerning when the news and media share outcomes from a single study. Often the implication is that the public should consider changing practices based on that one study.
I have a challenge for you, next time you hear about a new study and its interesting outcomes in the news, try and look closer. See if the study was one stand alone trial or if it is a systematic review of many studies used to look at the same issue.
Quality of Research
Quality of research is also very important; this will ensure that outcomes and conclusions are accurate.
There are several factors that make a research study high quality and valuable. This includes having a strong design with specific and detailed technique that enables others to do a similar study. Good studies will also use participants that are representative of larger groups of people. Additionally, good quality studies use ethical practices while conducting research.
Some elements that can make a research study weak and less valuable include too small of a sample size, having a conflict of interest, bias, low follow up with participants, and poor statistics during analysis.
How Good is the Nutrition Advice you are Following?
When you read nutrition advice in a book or on the internet, it is important to ask if the person is providing evidence based nutrition. There are many “nutrition experts” out there. Authors of nutrition that are not dietitians may not be providing information that is based on scientific studies. Instead, they may be offering information that they found off of the internet, or from their friend’s auntie. Or perhaps their information is anecdotal, “this worked for me.” They may have even read that their favorite celebrity recommended the bit of nutrition advice.
Word of mouth and the influence of others can be very convincing! While they usually mean well, some of this information may be more harmful than helpful. Think of popular fad diets, very low calorie diets, unnecessary avoidance of certain foods or even whole food groups, or use of expensive supplements that are not really needed.
Why People Choose to use Nutrition Advice That is not Evidence Based
Due to lack of research or conclusive research in different areas of health care, people will seek answers from other sources. People who are desperate for an answer or a cure may seek out other ways. The medical field will always need more research to continue making progress on treating or curing diseases.
People may also seek advice from an unreputable source because they want a quick fix. When you work with a dietitian, progress and results tend to be consistent but slower. Our culture tends to gravitate towards instant, quick and easy. Nutrition therapy that leads to long term desirable outcomes is typically going to incorporate lifestyle changes that can be followed the rest of your life.
Seek out Evidence Based Nutrition Advice
I encourage you to be choosy about where your nutrition information comes from. Don’t be afraid to ask questions. When in doubt, seek out a registered dietitian! Most hospital and health care systems will have a dietitian you can make an appointment with. Simply ask your doctor for a referral. If you are interested in seeking out a registered dietitian who has a private practice near you, you can search through the Academy of Nutrition and Dietetics’ website here.