Eat 40g of protein with every meal, ideally 4 hours apart.
Fast every night for 12-18 hours.
Switch to a vegan diet to live longer.
Eat animal protein to get leaner, faster.
Train for a better VO2 max - the important indicator for your longevity.
Prioritize resistance training over cardio for longevity.
An apple a day keeps the doctor away.
These are just some of the prescriptions for eternal youth and longevity you might have heard recently from your favorite podcast for YouTube channel. I'm not here to promote any of them, nor to counter any.
Instead, I want to highlight the phenomenon we're experiencing in the world of health and wellness - the rise of the health preacher.
A Critical Start: The Scientific Method
Before we had science, we had mythology and superstition. My well-meaning relatives still tell me regularly to avoid ice water and specific foods that will chill me and make me ill.
Although less mystical, science has a magic of its own in that it is explanable and provable. These are positive qualities especially in fields of health and medicine! The scientific method is crucial for evaluating health claims because it helps separate fact from fiction in a world of noise.
The scientific method is a framework for critical thinking with the following steps:
- Observe a phenomenon or problem: Scientists notice a high incidence of heart disease in a population of people whose diet doesn't include much fiber.
- Ask a testable question: Does consuming a high-fiber diet reduce the risk of heart disease?
- Propose a hypothesis: Consuming a high-fiber diet reduces the risk of heart disease by lowering cholesterol levels.
- Conduct an experiment: Scientists conduct a randomized controlled trial with high-fiber and low-fiber diet groups and measure cholesterol levels.
- Analyze the results: Scientists use statistical methods to determine the significance of their findings.
- Draw a conclusion: Based on the analysis, scientists conclude whether the hypothesis was supported or not.
- Share findings through peer-reviewed publications: Scientists publish their study in a reputable scientific journal for scrutiny and further research.
While imperfect (we can't easily apply the most rigorous scientific controls to certain topics, such as nutrition), it's the best tool we have for illuminating truth. Thankfully, society is starting to recognize that experts who use science to back up their claims are far more credible than those who do not. The problem is that many people are still relative beginners in distinguishing science from pseudoscience, thus leading to a great deal of confusion and hot debates about what is actually true.
Addicted to Information
Have you ever found yourself wondering about a headache, which led you to search about supplements, which then led you to like and subscribe to a health influencer that you then started listening to for the next three hours?
Information-seeking is an adaptive human behavior. We evolved to seek more information, to sleuth, to learn more about the world we live in and find solutions to our ailments.
However, in an age where info-seeking is as simple as a tap and a scroll, and our problems are seemingly magnified by the more we know, we end up in a vicious cycle of information addiction.
Some people are able to make it to the stage of balance where they incorporate valuable learnings into their lifestyle without getting to information overload. But most of us are stuck in the eternal trap of learning about something we're supposed to be doing for our health and beating ourselves up about not doing it (and scrolling some more to figure out if there's a cheat code for doing it faster and more easily).
This is the core instinct that helped the rise of powerful influencers in the world of health and wellness.
Seeking Authority
In 2020, we experienced an unprecedented pandemic...and saw the rise of "The Huberman Lab."
The success of Dr. Huberman (and other leading voices in health and wellness) is fascinating for many reasons, but the point here is just how enticing his style of communication has become for his followers.
Similarly popular health and wellness gurus such as Dr. Peter Attia, Dr. Rhonda Patrick, Dr. Mark Hyman, and a dozen others have followings of hundreds of thousands or even over a million (in the case of the prolific Mark Hyman).
Why are these leading health voices so attractive? It is partially due to their expertise, although even they will often admit their own podcast guests are the greater experts in many topics. It is a lot due to their charisma and communication style (a flavor and quality unfortunately not taught in medical or graduate school).
It's also greatly due to our inner desire for a voice of authority in a sea of noise.
While we presumably all learn the scientific method in grade school, the reality is most people are not equipped to read scientific journals and critique them properly. There are also vast gender and ethnic disparities in STEM education that lead to varying levels of health literacy.
Finally, who has the time to read anymore? As one friend expressed, "I'm a new dad and barely get enough sleep. I don't have time to read all the papers for myself. Who has the best podcast to distill all the info I need?"
Prescriptions and Pronouncements
How much protein should you eat? What is the best temperature for deep sleep? How many close, medium, and loose friends should you keep?
We once were a global society full of religion and spirituality. We sought answers in the pronouncements of religious leaders. This helped us decide where to live, how to live, and what to do while living each day.
Modern scientific inquiry has opened up the world of possibility; so much so that we can't handle the ambiguity. We look for pithy sayings and tldr;s to help us consume at a more reasonable pace. We pick camps to follow (Peter Attia vs. Rhonda Patrick on the topic of VO2 max training, etc.) and debate details on methods to achieve optimal health.
What is easier to remember, a full system of how to evaluate nutritious food options, or the Whole30 diet? Obviously, the latter. This is the reason for why simplistic diets (keto, carnivore, vegan, etc.) and health practices in general are stickier in people's minds.
Most of what is communicated on popular health platforms is valuable (yes, I'm a huge Huberman/Attia/Patrick/Hyman fan!). If nothing else, it drives up a lot more energy and enthusiasm about health and wellness - a fantastic outcome! But I would urge people to develop a more nuanced perspective and evaluate their chosen health "preacher" through a critical lens. Every message comes with bias, even if unintentional. Every person is pulled by incentives, even if unseen.
Experimenting with an N of 1
"There's more than one way to skin a cat." ~A strange idiom that aptly describes how to achieve peak health
It bears noting that all the studies in the world cannot reliably predict what will happen when each one of us, as individuals, attempt a new health intervention. We are each an experiment with an N of 1 with an unpredictable outcome depending on luck as much as intention. So while it's tempting to follow the pronouncements of doctors and influencers as "law," it is far more effective to try on frameworks with an air of careful experimentation.
For example, if you're curious about the benefits of intermittent fasting, start with a modest 12-hour fasting window and gradually increase it while monitoring how you feel and perform. If you're interested in a particular supplement, research the potential risks and benefits, consult with your healthcare provider, and start with a low dose to assess your individual response.
This, after all, is what we clinicians learn to do by trying various evidence-backed interventions, switching them for others when a planned experiment is not successful.
Finally, science is always revealing new knowledge that can change everything. Famously, menopausal hormonal replacement therapy used to be considered risky due to its correlation with a higher risk of breast cancer in the initial 10,739 subject Women's Health Initiative study (the study was even stopped early due to the observed 24% increase in breast cancer!). However, subsequent studies determined that the risks were more tied to the timing and formulation of the hormone interventions. Now, in a major reversal, many clinicians are coming around to recommending early HRT! This is an evolving field with new studies and interventions coming to market constantly, requiring each person to make an individual decision about when and how to start treatment.
Data, Data, Everywhere
Another challenge in personal health decision-making is how to handle data overload. Today, we have more data now than we ever have before. We now know how much of the body works and how it might break down. We have medical miracles preventing deaths due to infections and traumas. Breakthroughs in immunotherapy have changed the face of cancer medicine. There are well over 20 distinct medications to treat just hyperlipidemia, a major factor in heart disease.
Yet even with all this tech and $4.8T (trillion!) of healthcare spending each year, the richest nation in the world (US) has a terrible healthcare system compared to its peers. We're not even in the top 10 of any reputable healthcare system ranking (Commonwealth Fund 2021, WHO 2000, Bloomberg Healthiest Country Index 2019).
The full download of why this is true is extensive, but one reason is because we have not figured out how to apply the knowledge we have gained to real-life healthcare. So what if we prove that 30g of daily fiber intake improves heart health? Is that more or less important than multiple sessions of mindfulness practice per week? What about if the individual has crippling insomnia? Or if they're 100 vs. 300 lbs? Not to mention, would any of those optimizations go out the window in the face of vast socioeconomic, racial, ethnic, and gender disparities?
Science has changed the face of medicine and brought us incredible life-improving innovations. But we haven't cracked the code as to how we can apply the right data to the right patient in the right time. This level of specificity and omniscience may well be beyond our current knowledge capability (perhaps a challenge for a reader who happens to be a science philosopher?).
Awareness is Key When Fighting Pseudoscience
"If you can't convince them, confuse them."
~Harry S. Truman, maybe
Almost every single one of my patients tells me they get most of their health information from platforms like Instagram and TikTok. Herein lies a massive problem in health literacy. Social media has led to the evolution of language from meaningful prose to catchphrases and soundbites. With an epidemic of distraction and true clinical attention disorders (over 10% of Americans have been formally diagnosed with ADHD now, not to mention the undiagnosed), we have no ability to focus on the nuanced workings of the human body.
Because social media platforms optimize for engagement (keeping you on the app for as long as possible), they promote content that is punchy and eye-catching. This is why most people's feeds are filled with cute animals and scantily clad influencers. Even legitimate health voices must compete for airtime by reducing their message for simplicity (and sometimes reducing their clothing - I've seen this more than once!).
The most powerful voices on social media are unfortunately not the most knowledgeable or truthful. They are the most compelling, often because they say something that is just confusing enough to seem profound. They also overreach, generalizing a scientific study's findings for populations that weren't included in the research. Mouse studies lead to fitness interventions. Yeast studies become full-blown supplement lines. And don't get me started about how most clinical trials conducted are on primarily white male populations, so who knows how much we can extrapolate those data for ethnic minorities and non-males.
What's the solution here? Unfortunately, it's tough - each one of us needs a more sophisticated understanding of science and health to better critique the onslaught of confusing messages. Comprehensive health literacy is the true solution to fight pseudoscience.
In other words, we all need to get smart.
Breaking Through The Overwhelm
The world of health and wellness can be overwhelming, with countless voices vying for our attention and offering conflicting advice. But by developing a more sophisticated understanding of science and health, we can navigate this landscape with greater confidence and make informed decisions about our own well-being.
So, I encourage you to approach health claims with a critical eye, seek out reliable sources of information, and experiment carefully with different interventions to find what works best for you. Only with a critical eye can we fight the spread of pseudoscience and make health decisions that align best with our own life goals.
Quick Takeaways
I would be remiss if I didn't end my extensive essay about health communication with a kind of tldr; on how to get smart about health content.
- Fact-check claims by looking for reputable sources (peer-reviewed scientific journals or government health organizations).
- Watch out for signs of pseudoscience, such as anecdotal evidence, cherry-picked data, or claims that seem too good to be true.
- Seek out multiple perspectives on a given health topic, rather than relying on a single "authority" figure.
- Remember that individual responses to health interventions can vary widely, and what works for one person may not work for another.
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